132 results match your criteria Persistent Idiopathic Facial Pain

Acute and Chronic Pain from Facial Skin and Oral Mucosa: Unique Neurobiology and Challenging Treatment.

Int J Mol Sci 2021 May 28;22(11). Epub 2021 May 28.

Health Science Center at San Antonio, Programs in Integrated Biomedical Sciences, Department of Oral & Maxillofacial Surgery, School of Dentistry, Translational Sciences, Biomedical Engineering and Radiological Sciences, University of Texas, San Antonio, TX 78229, USA.

The oral cavity is a portal into the digestive system, which exhibits unique sensory properties. Like facial skin, the oral mucosa needs to be exquisitely sensitive and selective, in order to detect harmful toxins versus edible food. Chemosensation and somatosensation by multiple receptors, including transient receptor potential channels, are well-developed to meet these needs. Read More

View Article and Full-Text PDF

Idiopathic Facial Pain Syndromes.

Dtsch Arztebl Int 2021 Feb;118(6):81-87

Institute of Systems Neurosciences, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Oral and Maxillofacial Surgery (MKG), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Background: Idiopathic facial pain syndromes are relatively rare. A uniform classification system for facial pain became available only recently, and many physicians and dentists are still unfamiliar with these conditions. As a result, patients frequently do not receive appropriate treatment. Read More

View Article and Full-Text PDF
February 2021

Facial pain beyond trigeminal neuralgia.

Curr Opin Neurol 2021 Jun;34(3):373-377

Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London.

Purpose Of Review: Trigeminal neuralgia is a well-known facial pain syndrome with several treatment options. In contrast, non-neuralgiform idiopathic facial pain syndromes are relatively rare, reflected by the fact that, until 2020, no internationally accepted diagnostic classification existed. Like trigeminal neuralgia, these non-dental facial pain syndromes need to be managed by neurologists and pain specialists, but the lack of pathophysiological understanding has resulted in an underrepresented and undertreated patient group. Read More

View Article and Full-Text PDF

Oral appliances in the management of neuropathic orofacial pain: A retrospective case series.

Oral Dis 2021 Mar 1. Epub 2021 Mar 1.

Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.

Objective: Neuropathic orofacial pain disorders are frequently managed with topical or systemic medications that carry a risk of dangerous side effects such as drowsiness, disorientation, and/or physical addiction. The aim of this paper is to report the use of neurosensory oral appliances as a safe means of providing symptomatic relief for neuropathic orofacial pain.

Study Design: This is a retrospective chart review of patients with diagnoses of persistent idiopathic facial pain (PIFP), painful post-traumatic trigeminal neuropathy (PTTN), or an oral dysesthesia, who utilized neurosensory appliances with or without the use of topical anesthetic gel. Read More

View Article and Full-Text PDF

Evaluation of patients suffered from burning mouth syndrome and persistent idiopathic facial pain using Japanese version PainDETECT questionnaire and depression scales.

J Dent Sci 2021 Jan 7;16(1):131-136. Epub 2020 Jul 7.

Department of Anesthesiology, School of Dentistry, Aichi Gakuin University, Japan.

Background/purpose: Various questionnaires have been validated as methods for screening of neuropathic pain, but none have been established for the orofacial region. Although chronic pain and depression are likely to comorbid, few studies have examined the relationship between orofacial chronic pain and depression. Therefore, we evaluated the potential of the Japanese Version of PainDETECT as an assessment tool for neuropathic pain associated with burning mouth syndrome (BMS) and persistent idiopathic facial pain (PIFP). Read More

View Article and Full-Text PDF
January 2021

Characterization of head and neck pain symptoms of patients presenting to a tertiary care pain clinic.

Cranio 2020 Dec 19:1-6. Epub 2020 Dec 19.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.

To characterize the presentation and symptomatology of individuals presenting with pain in head and neck regions. A retrospective chart-review was performed on patients with pain in the HFN presenting to a tertiary pain center in Turkey between January 2016 and January 2017. Information regarding the characteristics of pain and medical and treatment history were extracted and reviewed. Read More

View Article and Full-Text PDF
December 2020

When orofacial pain needs a heart repair.

Clin Exp Dent Res 2021 Apr 28;7(2):263-267. Epub 2020 Nov 28.

Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy.

Objectives: The association of chronic orofacial pain (COFP) and congenital heart disease has never previously been reported. We report the first case of COFP secondary to a right-to-left shunt (RLS) due to asymptomatic patent foramen ovale (PFO) in a patient with prothrombotic states.

Materials And Methods: A 48-year-old female patient presented with a 10-month history of left-sided facial pain who was initially diagnosed with persistent idiopathic facial pain (PIFP) on account of its similar characteristics. Read More

View Article and Full-Text PDF

Outcomes of Occipital Nerve Stimulation for Craniofacial Pain Syndromes.

Can J Neurol Sci 2020 Nov 25:1-8. Epub 2020 Nov 25.

University of Calgary, Department of Clinical Neurosciences and Hotchkiss Brain Institute, Calgary, Alberta, Canada.

Objectives: Occipital nerve regional stimulation (ONS) is reported to improve pain in several studies. We examined long-term pain and functional outcomes of ONS in an open-label prospective study.

Methods: Patients with medically refractory and disabling craniofacial pain were prospectively selected for ONS. Read More

View Article and Full-Text PDF
November 2020

Challenges of Misdiagnosis and Suboptimal Treatment of Persistent Idiopathic Facial Pain and Atypical Odontalgia: A Retrospective Multi-Centric Cross-Sectional Investigation.

J Pain Res 2020 10;13:2853-2860. Epub 2020 Nov 10.

Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.

Purpose: To explore the challenges faced in the diagnosis and treatment of atypical odontalgia (AO) and other persistent idiopathic facial pain (PIFP).

Patients And Methods: This retrospective multi-centric cross-sectional study utilized clinical information (eg, clinical manifestations, history of consultations and treatments prior to correct diagnoses) from patients' medical records. Their economic parameters were also extracted from medical insurance databases. Read More

View Article and Full-Text PDF
November 2020

Altered trigeminal pain processing on brainstem level in persistent idiopathic facial pain.

Pain 2021 05;162(5):1374-1378

Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Abstract: Persistent idiopathic facial pain (PIFP) is a poorly understood chronic pain syndrome of the face, formerly known as atypical facial pain. It is characterized by a constant painful sensation without neurological abnormalities and without clinically objectifiable cause. Similarities to neuropathic pain conditions have been discussed and are currently thought to be relevant for the pathophysiology of this disease. Read More

View Article and Full-Text PDF

Orofacial pain education in dentistry: A path to improving patient care and reducing the population burden of chronic pain.

J Dent Educ 2021 Mar 23;85(3):349-358. Epub 2020 Oct 23.

Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan.

Dentists stand in an optimal position to prevent and manage patients suffering from chronic orofacial pain (OFP) disorders, such as temporomandibular disorders, burning mouth syndrome, trigeminal neuralgia, persistent idiopathic dentoalveolar pain, among others. However, there are consistent reports highlighting a lack of knowledge and confidence in diagnosing and treating OFP among dental students, recent graduates, and trained dentists, which leads to misdiagnosis, unnecessary costs, delay in appropriate care and possible harm to patients. Education in OFP is necessary to improve the quality of general dental care and reduce individual and societal burden of chronic pain through prevention and improved quality of life for OFP patients. Read More

View Article and Full-Text PDF

Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome-An Evidence-Based Narrative Review and Etiological Hypothesis.

Robert Gerwin

Int J Environ Res Public Health 2020 09 25;17(19). Epub 2020 Sep 25.

Department of Neurology School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.

Trigeminal neuralgia (TN), the most common form of severe facial pain, may be confused with an ill-defined persistent idiopathic facial pain (PIFP). Facial pain is reviewed and a detailed discussion of TN and PIFP is presented. A possible cause for PIFP is proposed. Read More

View Article and Full-Text PDF
September 2020

Clinical presentations on a facial pain clinic.

Br Dent J 2020 Sep 11. Epub 2020 Sep 11.

Sheffield Teaching Hospitals NHS Foundation Trust, Oral Surgery, Charles Clifford Dental Hospital, 76 Wellesley Road, Sheffield, South Yorkshire, S10 2SZ, UK; Department of Oral and Maxillofacial Surgery, School of Clinical Dentistry, University of Sheffield, Charles Clifford Dental Hospital, Wellesley Road, Sheffield, S10 2TA, UK.

Introduction The complex nature of facial pain conditions creates a diagnostic challenge which may necessitate specialist referral.Aim To identify the case mix presenting to a specialist tertiary care facial pain clinic.Methods A retrospective review of 112 patient records was undertaken. Read More

View Article and Full-Text PDF
September 2020

Gasserian Ganglion Stimulation for Facial Pain.

Prog Neurol Surg 2020 28;35:96-104. Epub 2020 Jul 28.

Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA,

Non-neuralgic trigeminal neuropathic pain can be challenging in terms of treatment as pharmacological interventions often tend to be ineffective. Within the pain-transmitting pathway, the Gasserian ganglion (GG) is a rather unique anatomical and physiological structure where the sensory (including pain) information from the entire half of the face undergoes primary processing in a very compact and clearly defined entity. Moreover, GG is positioned in a completely immobile intradural location (the Meckel's cave) and is insulated from the brain by a layer of dura. Read More

View Article and Full-Text PDF

Repetitive percutaneous radiofrequency thermocoagulation for persistent idiopathic facial pain and central neuropathic pain attributed to multiple sclerosis-a retrospective monocentric analysis.

Acta Neurochir (Wien) 2020 11 14;162(11):2791-2800. Epub 2020 Jul 14.

Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.

Background: Persistent idiopathic facial pain (PIFP) is a debilitating chronic pain condition with pain radiating to trigeminal dermatomes. Typically, there are no pathological findings that can be identified during workup and therapy is symptomatic. Facial pain is common in patients with multiple sclerosis (central neuropathic pain attributed to MS). Read More

View Article and Full-Text PDF
November 2020

Predictive role of gnathological techniques for the treatment of persistent idiopathic facial pain (PIFP).

Neurol Sci 2020 Nov 21;41(11):3315-3319. Epub 2020 May 21.

Igea Healthcare Institute, Milan, Italy.

Introduction/background: Persistent idiopathic craniofacial pain (PIFP) is a heterogeneous group of pain syndromes whose main characteristic is the daily presence of persistent pain for at least 3 months. The pathophysiology of PIFP is still not entirely known and probably related to biological and psychological factors. Although PIFP has been attributed to the central neuron activity, the importance of masticatory muscles as a possible pathogenic mechanism was recently demonstrated. Read More

View Article and Full-Text PDF
November 2020

Facial Pain: A Comprehensive Review and Proposal for a Pragmatic Diagnostic Approach.

Eur Neurol 2020 27;83(1):5-16. Epub 2020 Mar 27.

Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Headache and Facial Pain Clinic, Brussels, Belgium,

Background: Facial pain, alone or combined with other symptoms, is a frequent complaint. Moreover, it is a symptom situated at, more than any other pain condition, a crosspoint where several disciplines meet, for example, dentists; manual therapists; ophthalmologists; psychologists; and ear-nose-throat, pain, and internal medicine physicians besides neurologists and neurosurgeons. Recently, a new version of the most widely used classification system among neurologists for headache and facial pain, the International Classification of Headache Disorders, has been published. Read More

View Article and Full-Text PDF
November 2020

A case of an elderly patient with persistent idiopathic facial pain related to dental implants successfully treated with mirtazapine.

Psychogeriatrics 2020 09 11;20(5):769-770. Epub 2020 Mar 11.

Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

View Article and Full-Text PDF
September 2020

Differences in the Clinical Characteristics of Persistent Idiopathic Facial Pain (Atypical Odontalgia) Patients with or Without Neurovascular Compression of the Trigeminal Nerve.

Pain Med 2020 04;21(4):814-821

Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Background: Persistent idiopathic facial pain (PIFP) is the unexplained pain along the territory of the trigeminal nerve, including nonorganic tooth pain called atypical odontalgia (AO). Though PIFP is debilitating to patients' livelihood and well-being, its pathophysiology remains poorly understood. Although neurovascular compression (NVC) of the trigeminal nerve is known to be associated with trigeminal neuralgia (TN), the relationship between NVC and other orofacial pains has not been fully elucidated. Read More

View Article and Full-Text PDF

Persistent dentoalveolar pain disorder: A putative intraoral chronic overlapping pain condition.

Oral Dis 2020 Nov 17;26(8):1601-1609. Epub 2019 Dec 17.

Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.

Chronic overlapping pain conditions (COPCs) are conditions that share several clinical characteristics and symptomatology, are usually considered idiopathic in nature, and are frequently comorbid. Currently, there are no established inclusion criteria to determine which conditions should be included under this umbrella term despite different systems proposed. Persistent dentoalveolar pain disorder (PDAP), also referred to as atypical odontalgia and thought to be a component of persistent idiopathic facial pain, is a chronic pain condition that manifests as a persistent tooth pain or pain over a dentoalveolar site formerly occupied by a tooth in the absence of detectable pathology during clinical or radiological examination. Read More

View Article and Full-Text PDF
November 2020

Atypical Facial Pain.

Dent Clin North Am 2020 01 21;64(1):249-253. Epub 2019 Oct 21.

Department of Dentistry/Oral and Maxillofacial Surgery, Woodhull Medical Center, 2c320, Brooklyn, NY 11203, USA.

Atypical facial pain (AFP), or persistent idiopathic facial pain, is a chronic and diffuse distribution of facial pain along the territory of the trigeminal nerve. This condition occurs in the absence of any neurologic deficit or any other obvious etiology. AFP is one of the most challenging conditions to diagnose due to lack of clear diagnostic criteria. Read More

View Article and Full-Text PDF
January 2020

Clinical Presentation, Management, and Outcomes of Idiopathic Pain in Percutaneous Bone-anchored Hearing Implants.

Otol Neurotol 2019 12;40(10):1292-1298

Department of Otorhinolaryngology, Donders Center for Neurosciences.

Objective: To identify clinical features and investigate treatment outcomes of patients with idiopathic pain related to a percutaneous bone-anchored hearing implant (BAHI) and to propose management recommendations.

Study Design: Retrospective chart analysis.

Setting: Tertiary referral center. Read More

View Article and Full-Text PDF
December 2019

Differential Diagnosis of Chronic Neuropathic Orofacial Pain: Role of Clinical Neurophysiology.

J Clin Neurophysiol 2019 Nov;36(6):422-429

Department of Clinical Neurophysiology, Turku University Hospital and University of Turku, Turku, Finland.

Orofacial pain syndromes encompass several clinically defined and classified entities. The focus here is on the role of clinical neurophysiologic and psychophysical tests in the diagnosis, differential diagnosis, and pathophysiological mechanisms of definite trigeminal neuropathic pain and other chronic orofacial pain conditions (excluding headache and temporomandibular disorders). The International Classification of Headache Disorders 2018 classifies these facial pain disorders under the heading Painful cranial neuropathies and other facial pains. Read More

View Article and Full-Text PDF
November 2019

Neuropathic Characteristics In Patients With Persistent Idiopathic Facial Pain.

J Pain Res 2019 27;12:2801-2805. Epub 2019 Sep 27.

Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Hyogo, Japan.

Background: Persistent idiopathic facial pain (PIFP) is a subtype of painful cranial neuropathies and other facial pains. The involvement of neuropathic mechanisms in PIFP, however, remains controversial. Using the Douleur Neuropathique 4 (DN4) questionnaire, the present study examined neuropathic characteristics in patients with PIFP. Read More

View Article and Full-Text PDF
September 2019

Persistent Idiopathic Facial Pain Originating from Cervical Abnormalities.

Yuan-Jie Zeng

World Neurosurg 2020 Jan 16;133:248-252. Epub 2019 Oct 16.

Joint Surgery and Sport Medicine Department, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China. Electronic address:

Background: Persistent idiopathic facial pain is characterized by persistent facial or oral pain in the absence of a neurologic deficit. This underexplored pain may be conducted by various nerves, including cranial nerves and upper cervical spinal roots, and its etiology is unclear.

Case Description: A patient presented with persistent idiopathic facial pain associated with occipital muscle stiffness after an improper neck massage. Read More

View Article and Full-Text PDF
January 2020

Suspected trigeminal nerve neuropathy causing persistent idiopathic facial pain: a report of four cases.

J Can Chiropr Assoc 2019 Aug;63(2):126-138

Canadian Memorial Chiropractic College.

Persistent idiopathic facial pain is often a disabling condition for patients. Due to a lack of agreed upon diagnostic criteria and varied symptomatology, the diagnosis of persistent idiopathic facial pain is elusive and remains one of exclusion. It is typically described as a unilateral, deep, poorly localized pain in the territory of the trigeminal nerve, however there are a number of case reports that describe bilateral symptoms. Read More

View Article and Full-Text PDF

The specialist management of non-temporomandibular orofacial pain: maxillofacial surgery's known unknown?

Br J Oral Maxillofac Surg 2019 10 12;57(8):749-754. Epub 2019 Jul 12.

Eastman Dental Institute, University College London Hospital; Department of Facial Pain and Oral Medicine, Eastman Dental Hospital, 256 Grays Inn Road, London, WC1X8LD.

The management of orofacial pain is considered to be within the remit of oral and maxillofacial surgery (OMFS). In this study we aimed to provide an overview of the healthcare "journey" of a group of patients referred to a specialist unit with "complex" non-temporomandibular orofacial pain. We retrospectively reviewed all those who were referred over a six-month period and followed for up to three years. Read More

View Article and Full-Text PDF
October 2019

Aids to management of headache disorders in primary care (2nd edition) : on behalf of the European Headache Federation and Lifting The Burden: the Global Campaign against Headache.

J Headache Pain 2019 May 21;20(1):57. Epub 2019 May 21.

Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.

The Aids to Management are a product of the Global Campaign against Headache, a worldwide programme of action conducted in official relations with the World Health Organization. Developed in partnership with the European Headache Federation, they update the first edition published 11 years ago.The common headache disorders (migraine, tension-type headache and medication-overuse headache) are major causes of ill health. Read More

View Article and Full-Text PDF

Diagnostic delay and suboptimal management in persistent idiopathic facial pain and persistent dentoalveolar pain; a cross-sectional study.

Oral Surg Oral Med Oral Pathol Oral Radiol 2019 Jun 22;127(6):498-503. Epub 2019 Feb 22.

School of Dentistry, The University of Jordan, Amman, Jordan.

Objectives: The aim of this study was to explore the diagnostic and therapeutic challenges encountered by patients with persistent idiopathic facial pain (PIFP) and to investigate factors influencing its delayed diagnosis.

Study Design: In this cross-sectional study, 34 patients with newly diagnosed PIFP were interviewed. Data about diagnostic delay, number and nature of previous consultations, and previous medical and surgical interventions were recorded. Read More

View Article and Full-Text PDF

Percutaneous Trigeminal Nerve Stimulation for Persistent Idiopathic Facial Pain: A Case Series.

World Neurosurg 2019 Jun 20;126:e1379-e1386. Epub 2019 Mar 20.

Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.

Background: Persistent idiopathic facial pain (PIFP) can be refractory to conventional management approaches. Neuromodulatory procedures such as percutaneous trigeminal nerve stimulation (TNS) have been sparsely reported as potential treatment options for amelioration of debilitating refractory pain associated with PIFP. The present study investigated the use of percutaneous TNS in a series of patients with PIFP to evaluate the potential efficacy of pain relief. Read More

View Article and Full-Text PDF