What is atypical facial pain?

The term “atypical facial pain” has often been used to refer to any facial pain other than classic trigeminal neuralgia. However, this term more properly describes a type of deep burning, throbbing, or aching pain, usually confined to one side of the face but sometimes affecting both sides. It is usually constant but can have occasional brief, stabbing components. Unlike trigeminal neuralgia, there are no trigger zones. It occurs much more frequently in women than in men, and may occur following minor trauma or dental procedures.

Treatment options

The cause of atypical facial pain is unknown. However, in the majority of patients there is a marked degree of depression and anxiety which can contribute to worsening of the pain. Tricyclic antidepressants such as amitriptyline (Elavil) have been used to treat atypical facial pain, with complete relief in up to 80% of patients. The surgical treatment of atypical facial pain is controversial. Procedures which destroy parts of the nervous system are not indicated for treatment of this condition. Stimulation procedures such as deep brain stimulation or motor cortex stimulation may be somewhat effective, but should be reserved for patients who have failed to respond to an adequate trial of medication and who are actively participating in psychological treatment and counseling.

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