When patients have chronic headache or facial pain that doesn’t fit any other category it is often diagnosed as Atypical Facial Pain. Other terms used for this include Atypical facial neuralgia, Trigeminal Neuralgia or tic douloureux, atypical trigeminal neuralgia, Spenopalatine Ganglion neuralgia, Sluders neuralgia,idiopathic facial pain. It is often considered to be a “psychogenic pain”
Because the cause is often unknown the term idiopathic facial pain may be most accurate as it literally means “we are idiots at knowing the cause of this pain”
Atypical facial pain, is often compared to trigeminal neuralgia but is a separate and different entity. Symptoms can be very persistent often lasting months or years and can be described in terms including burning, sharp, dull, crushing, aching, scalding , twisting, pulling or squeezing.
With multiple possible causes of atypical facial pain the diagnosis is usually reached through a process of elimination. Some cases are related to the Sphenopalatine Ganglion and present with multiple autonomic symptoms.
Trigeminal Neuralgia Referral: https://thinkbetterlife.com/referrals/
Atypical facial pain was once considered to be a strictly psychological disorder or psychogenic disorder. Many practitioners still consider patients pain as psychogenic and downplay neurological causes. it is unquestionably a disorder wholly or partially of the trigeminal nervous system. Possible cause include:
Sinus infections
Dental infections
Ernest Syndrome (inflammation of a ligament in the jaw)
Neuralgia inducing cavitational osteonecrosis
Temporal tendonitis
Trigeminal ganglia compression
Trigeminal nerve trauma
The above are all structures innervated primarily by the Trigeminal nerve.
Vagus nerve tumors: A rare cause of pain
Facial trauma: Trauma to Facial and/or Trigeminal Nerve
Cervical spine disorders: As related to Trigeminal Cerical Complex
Treatment options by neurologists are usually prescription drugs used for depression, seizures such as:
Amitriptyline (antidepressant)
Gabapentin (anticonvulsant)
Carbamazepine (anticonvulsant)
Baclofen (muscle relaxant/antispasmodic)
Clonazepam (muscle relaxant/anticonvulsant)
Valproic (anticonvulsant)
Invasive therapies include Microvascular decompression, Balloon compression, Glycerol injection, Peripheral nerve stimulation (ULF-TENS utilized in physiologic dentistry), Stereotactic radiosurgery, Percutaneous trigeminal tractotomy, Motor cortex stimulation. One excelent approach that often has success without defining the actual disorder is the SPG Block or Sphenopalatine Ganglion Block.
Self Administered SPG Blocks can frequently give almost miraculous relief to Trigeminal Neuralgia. Learn more at: https://www.sphenopalatineganglionblocks.com/trigeminal-neuralgia-first-line-approach-spg-blocks-can-safe-effective/
Physiologic Dentistry can often provide answers by correcting the underlying triggers of this type of pain. ULF-TENS, SPG Blocks, Trigger Point Injections and Diagnostic Physiologic Orthotics often provide relief without a definitive diagnosis.
The nature of Atypical Facial Pain is NO DIAGNOSIS. If the tretment is treated successfully it is usually assumed that treatment addressed the underlying cause and therefore the patient did not actually have atypical facial pain.
