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Current Pain and Headache Reports
Erschienen in: Current Pain and Headache Reports 2/2017

01.02.2017 | Other Pain (N Vadivelu and A Kaye, Section Editors)

Atypical Facial Pain: a Comprehensive, Evidence-Based Review

verfasst von: Austin L. Weiss, Ken P. Ehrhardt, Reda Tolba

Erschienen in: Current Pain and Headache Reports | Ausgabe 2/2017

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Abstract

Purpose of Review

The purpose of this article is to focus on an excruciating disorder of the face, named atypical facial pain or persistent idiopathic facial pain (PIFP). It is considered an underdiagnosed condition with limited treatment options. Facial pain can be a debilitating disorder that affects patients’ quality of life. Up to 26% of the general population has suffered from facial pain at some point in their lives. It is important to highlight the different types of facial pain to be able to properly manage this condition accordingly.

Recent Findings

Newer interventional modalities such as pulsed radiofrequency ablation (PFR) of the sphenopalatine ganglion, peripheral nerve field stimulators (PNFS), and botulinum toxin injections have promising results. In summary, more prospective studies such as randomized controlled trials are necessary to explore the possibility of their more widespread use as viable procedures for the treatment of PIFP.

Summary

In this review article, we describe the workup and diagnosis of PIFP and highlight recent literature regarding the pathophysiology and treatment of PIFP. PIFP is an excruciating disorder of the face often misdiagnosed as trigeminal neuralgia (TN) However, unlike TN symptoms, the pain is persistent rather than intermittent, usually unilateral, and without autonomic signs or symptoms. When a clinician encounters a patient with neuropathic facial pain whose symptoms are incongruent with the more common etiologies, the diagnosis of atypical facial pain must be entertained. Treatment of PIFP is multidisciplinary. Unfortunately, few randomized controlled trials for the treatment of PIFP exist. However, there are a select number of pharmacological, non-pharmacological, and interventional treatment options that have proven to be moderately effective.
Literatur
1.
Macfarlane TV, Blinkhorn AS, Davies RM, et al. Oro-facial pain in the community: prevalence and associated impact. Community Dent Oral Epidemiol. 2002;30(1):52–60.CrossRefPubMed
2.
Obermann M, Holle D, Katsarava Z. Trigeminal neuralgia and persistent idiopathic facial pain. Expert review of neurotherapeutics. 2011;11(11):1619–29.CrossRefPubMed
3.
Mueller D, Obermann M, Yoon MS, et al. Prevalence of trigeminal neuralgia and persistent idiopathic facial pain: a population-based study. Cephalalgia. 2011;31(15):1542–8.CrossRefPubMed
4.
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808.CrossRef
5.
Zakrzewska JM. Differential diagnosis of facial pain and guidelines for management. Br J Anaesth. 2013;111(1):95–104.CrossRefPubMed
6.
Vadivelu N, Vadivelu A, Kaye AD. Orofacial pain: a clinician’s guide. Switzerland: Springer; 2014.CrossRef
7.
Slade GD. Epidemiology of dental pain and dental caries among children and adolescents. Community Dent Health. 2001;18(4):219–27.PubMed
8.
Brennan DS, Spencer AJ, Roberts-Thomson KF. Quality of life and disability weights associated with periodontal disease. J Dent Res. 2007;86(8):713–7.CrossRefPubMed
9.
Manzoni GC, Torelli P. Epidemiology of typical and atypical craniofacial neuralgias. Neurol Sci. 2005;26 Suppl 2:s65–7.CrossRefPubMed
10.
Suzuki N, Mashu S, Toyoda M, et al. Oral burning sensation: prevalence and gender differences in a Japanese population. Pain Pract. 2010;10(4):306–11.CrossRefPubMed
11.
Bergdahl M, Bergdahl J. Burning mouth syndrome: prevalence and associated factors. J Oral Pathol Med. 1999;28(8):350–4.CrossRefPubMed
12.
Penna PP, Recupero M, Gil C. Influence of psychopathologies on craniomandibular disorders. Braz Dent J. 2009;20(3):226–30.CrossRefPubMed
13.
Abetz LM, Savage NW. Burning mouth syndrome and psychological disorders. Aust Dent J. 2009;54(2):84–93. quiz 173.CrossRefPubMed
14.
Aggarwal VR, Macfarlane GJ, Farragher TM, et al. Risk factors for onset of chronic oro-facial pain-results of the North Cheshire oro-facial pain prospective population study. Pain. 2010;149(2):354–9.CrossRefPubMedPubMedCentral
15.
Mohan H, Tahlan A, Mundi I, et al. Non-neoplastic salivary gland lesions: a 15-year study. Eur Arch Otorhinolaryngol. 2010;268(8):1187–90.CrossRefPubMed
16.
17.
Melis M, Lobo SL, Ceneviz C, et al. Atyical odontalgia: a review of the literature. Headache. 2003;43(10):1060–74.CrossRefPubMed
18.
Forssell H, Jaaskelainen S, List T, Svensson P, Baad-Hansen L. An update on pathophysiological mechanisms related to idiopathic oro-facial pain conditions with implications for management. J Oral Rehabil. 2015;42(4):300–22.CrossRefPubMed
19.
Jääskeläinen SK, Forssell H, Tenovuo O. Electrophysiological testing of the trigeminofacial system: aid in the diagnosis of atypical facial pain. Pain. 1999;80(1):191–200.CrossRefPubMed
20.
Lang E, Kaltenhäuser M, Seidler S, Mattenklodt P, Neundörfer B. Persistent idiopathic facial pain exists independent of somatosensory input from the painful region: findings from quantitative sensory functions and somatotopy of the primary somatosensory cortex. Pain. 2005;118(1):80–91.CrossRefPubMed
21.
Jääskeläinen SK, Rinne JO, Forssell H, et al. Role of the dopaminergic system in chronic pain—a fluorodopa-PET study. Pain. 2001;90(3):257–60.CrossRefPubMed
22.
Hagelberg N, Forssell H, Aalto S, et al. Altered dopamine D2 receptor binding in atypical facial pain. Pain. 2003;106(1):43–8.CrossRefPubMed
23.
Hagelberg N, Forssell H, Rinne JO, et al. Striatal dopamine D1 and D2 receptors in burning mouth syndrome. Pain. 2003;101(1):149–54.CrossRefPubMed
24.
Wood PB. Role of central dopamine in pain and analgesia. Expert review of neurotherapeutics. 2008;8(5):781–97.CrossRefPubMed
25.
Taiminen T, Kuusalo L, Lehtinen L, et al. Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain. Scandinavian Journal of Pain. 2011;2(4):155–60.CrossRef
26.
Zakrzewska JM, Hamlyn PJ. Facial pain. In: Crombie IK, editor. Epidemiology of pain. Seattle: IASP Press; 1999. p. 171–202.
27.
Cornelissen P, van Kleef M, Mekhail N, Day M, van Zundert J. Evidence-based interventional pain medicine according to clinical diagnoses. 3. Persistent idiopathic facial pain. Pain Pract. 2009;9(6):443–8.CrossRefPubMed
28.
Forssell H, Tasmuth T, Tenovuo O, Hampf G, Kalso E. Venlafaxine in the treatment of atypical facial pain: a randomized controlled trial. J Orofac Pain. 2004;18(2):131–7.PubMed
29.
30.
31.
Harrison S, Glover L, Maslin L, Feinmann C, Pearce S, Harris M. A comparison of antidepressant medication alone and in conjunction with cognitive behavioural therapy for chronic idiopathic facial pain. In: Jensen G, Turner JA, Weisenfeld-Hallin Z, editors. Proceedings of the 8th World Congress on Pain: progress in pain research and management, vol. 8. Seattle: IASP Press; 1997. p. 663–72.
32.
Abrahamsen R, Baad-Hansen L, Svensson P. Hypnosis in the management of persistent idiopathic orofacial pain—clinical and psychosocial findings. Pain. 2008;136(1–2):44–52.CrossRefPubMed
33.
• Zakrzewska JM. Chronic/persistent idiopathic facial pain. Neurosurg Clin N Am. 2016;27(3):345–51. Stress coping strategies and treatment of underlying psychological disorders is a key factor for multimodal management of patients with PIFP.CrossRefPubMed
34.
• McDonough P, McKenna JP, McCreary C, Downer EJ. Neuropathic orofacial pain: cannabinoids as a therapeutic avenue. Int J Biochem Cell Biol. 2014;55:72–8. Cannabinoids treatment has been a hot topic of interest for treatment of chronic painful conditions, including PIFP.CrossRefPubMed
35.
Dalton VS, Zavitsanou K. Differential treatment regimen-related effects of cannabinoids on D1 and D2 receptors in adolescent and adult rat brain. J Chem Neuroanat. 2010;40(4):272–80.CrossRefPubMed
36.
Bayer E, Racz GB, Miles D, Heavner J. Sphenopalatine ganglion pulsed radiofrequency treatment in 30 patients suffering from chronic face and head pain. Pain Practice. 2005;5(3):223–7.CrossRefPubMed
37.
Narouze SN. Interventional management of head and face pain: nerve blocks and beyond. New York: Springer; 2014.CrossRef
38.
•• Akbas M, Gunduz E, Sanli S, Yegin A. Sphenopalatine ganglion pulsed radiofrequency treatment in patients suffering from chronic face and head pain. Braz J Anesthesiol. 2016;66(1):50–4. Novel techniques such as pulsed radiofrequency ablation of the sphenopalatine ganglion have been studied and used for treatment of PIFP as well as other forms of facial pain.CrossRefPubMed
39.
•• Klein J, Sandi-Gahun S, Schackert G, Juratli TA. Peripheral nerve field stimulation for trigeminal neuralgia, trigeminal neuropathic pain, and persistent idiopathic facial pain. Cephalalgia. 2016;36(5):445–53. Emerging technologies in the field of neuromodulation such as peripheral nerve stimulation are promising options for patients suffering from IPFP.CrossRefPubMed
40.
•• Cuadrado ML, Garcia-Moreno H, Arias JA, Pareja JA. Botulinum neurotoxin type-A for the treatment of atypical odontalgia. Pain Med. 2016. Injection of neurotoxins such as botulinum toxins could be a promising treatment option for patients suffering from facial pain.
41.
Pessoa BL, Escudeiro G, Nascimento OJ. Emerging treatments for neuropathic pain. Curr Pain Headache Rep. 2015;19(12):1–9.CrossRef
42.
•• Mittal SO, Safarpour D, Jabbari B. Botulinum toxin treatment of neuropathic pain. Seminars in Neurology. 2016;36(01):073–83. Injection of neurotoxins such as botulinum toxins could be a promising treatment option for patients suffering from facial pain.CrossRef
Metadaten
Titel
Atypical Facial Pain: a Comprehensive, Evidence-Based Review
verfasst von
Austin L. Weiss
Ken P. Ehrhardt
Reda Tolba
Publikationsdatum
01.02.2017
Verlag
Springer US
Erschienen in
Current Pain and Headache Reports / Ausgabe 2/2017
Print ISSN: 1531-3433
Elektronische ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-017-0609-9

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