Introduction
Atypical Facial Pain (ATFP) is a syndrome that encompasses a wide group of facial pain problems.
This condition is typically characterized by a burning, aching or cramping sensation, occurring on one side of the face, often in the region of the trigeminal nerve. It can even extend further into the upper neck or back of the scalp.
ATFP and Other Conditions
For the purpose of effective pain management, atypical facial pain must be distinguished properly from other conditions. A few conditions, which might have similar symptoms include:
• Trigeminal neuralgia
• Temporomandibular joint syndrome (TMJ)
• Migraines
• Cluster headaches
Some studies also report that atypical facial pain is an early form of trigeminal neuralgia. Meanwhile some patients have components of both, trigeminal neuralgia as well as atypical facial pain. Though ATFP might be as severe as trigeminal neuralgia, yet the patterns and quality of the two conditions are quite different.
Causative Factors
ATFP is a comprehensive term, including a vast group of facial pain conditions and consequently having a series of possible causes. Quite often, an injury of any peripheral or proximal branch of trigeminal nerve due to facial trauma or basal skull fracture can cause the disorder.
Here we list some of the other causes of the condition of ATFP:
• Sinus or teeth infections
• Dental decay or infections
• Neuralgia including cavitational osteonecrosis
• Stylomandibular ligament sprains or Ernest Syndrome
• Temporal Tendonitis
• Myofascial trigger points
• Diseases and disorders of the cervical spine
• Tumors affecting the Vagus Nerve in the region of the lung or esophagus
Research also indicates that the vascular compression of the trigeminal ganglia in the same area that is believed to cause certain types of trigeminal neuralgia can also cause ATFP.
Diagnosis
Atypical facial pain syndrome is one of the most misdiagnosed pain conditions. It is quite common for a patient with ATFP to be first treated for dental procedures and to have gone through a series of other tests before being successfully diagnosed with ATFP.
A diagnosis of ATFP generally follows a process of elimination. Tests involved in this process include roentgenograms of the skull, MRI and/or CT scan, detailed dental and otolaryngolgic evaluation and a neurological examination.
Treatment Options
Treatment options for atypical facial pain normally begin with medications, followed by other forms of treatment. Here we briefly list the main forms of treatment recommended for the condition of ATFP:
A) Medications
• Amitriptyline (Triptyl, Elavil)
• Gabapentin (Neurontin)
• Pregabalin (Lyrica)
• Capsaicin
B) Hot and cold compresses
C) Acupuncture
D) Biofeedback
E) Dental Splint
In addition, people suffering from ATFP also seem to be more vulnerable to clinical depression, In fact, for many patients with such pain, treatment for depression can reduce pain levels or make it at least possible to manage pain for a better quality of life.
