Idiopathic Facial Pain Syndromes–An Overview and Clinical Implications
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Idiopathic Facial Pain Syndromes–An Overview and Clinical Implications. / Ziegeler, Christian; Beikler, Thomas; Gosau, Martin; May, Arne.
In: DTSCH ARZTEBL INT, Vol. 118, No. 6, 12.02.2021, p. 81-87.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Idiopathic Facial Pain Syndromes–An Overview and Clinical Implications
AU - Ziegeler, Christian
AU - Beikler, Thomas
AU - Gosau, Martin
AU - May, Arne
PY - 2021/2/12
Y1 - 2021/2/12
N2 - 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.METHODS: This article is based on pertinent publications retrieved by a selective search in PubMed, focusing on current international guidelines and the International Classification of Orofacial Pain (ICOP).RESULTS: The ICOP subdivides orofacial pain syndromes into six major groups, the first three of which consist of diseases of the teeth, the periodontium, and the temporomandibular joint. The remaining three groups (non-dental facial pain) are discussed in the present review. Attack-like facial pain syndromes most closely resemble the well-known primary headache syndromes, such as migraine, but with pain located below the orbitomeatal line. These syndromes are treated in accordance with the guidelines for the corresponding types of headache. Persistent idiopathic facial pain (PIFP) is a chronic pain disorder with persistent, undulating pain in the face and/or teeth, without any structural correlate. Since this type of pain tends to become chronified after invasive procedures, no dental procedures should be performed to treat it if the teeth are healthy; rather, the treatmentis similar to that of neuropathic pain, e.g., with antidepressant and anticonvulsive drugs. Neuropathic facial pain is also undulating and persistent. It is often described as a burning sensation, and neuralgiform attacks may additionally be present. Trigeminal neuralgia is a distinct condition involving short-lasting, lancinating pain of high intensity with a maximum duration of two minutes. The first line of treatment is with medications; invasive treatment options should be considered only if pharmacotherapy is ineffective or poorly tolerated.CONCLUSION: With the aid of this pragmatic classification system, the clinician can distinguish persistent and attack-like primary facial pain syndromes rather easily and treat each syndrome appropriately.
AB - 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.METHODS: This article is based on pertinent publications retrieved by a selective search in PubMed, focusing on current international guidelines and the International Classification of Orofacial Pain (ICOP).RESULTS: The ICOP subdivides orofacial pain syndromes into six major groups, the first three of which consist of diseases of the teeth, the periodontium, and the temporomandibular joint. The remaining three groups (non-dental facial pain) are discussed in the present review. Attack-like facial pain syndromes most closely resemble the well-known primary headache syndromes, such as migraine, but with pain located below the orbitomeatal line. These syndromes are treated in accordance with the guidelines for the corresponding types of headache. Persistent idiopathic facial pain (PIFP) is a chronic pain disorder with persistent, undulating pain in the face and/or teeth, without any structural correlate. Since this type of pain tends to become chronified after invasive procedures, no dental procedures should be performed to treat it if the teeth are healthy; rather, the treatmentis similar to that of neuropathic pain, e.g., with antidepressant and anticonvulsive drugs. Neuropathic facial pain is also undulating and persistent. It is often described as a burning sensation, and neuralgiform attacks may additionally be present. Trigeminal neuralgia is a distinct condition involving short-lasting, lancinating pain of high intensity with a maximum duration of two minutes. The first line of treatment is with medications; invasive treatment options should be considered only if pharmacotherapy is ineffective or poorly tolerated.CONCLUSION: With the aid of this pragmatic classification system, the clinician can distinguish persistent and attack-like primary facial pain syndromes rather easily and treat each syndrome appropriately.
KW - Facial Neuralgia/diagnosis
KW - Facial Pain/diagnosis
KW - Headache
KW - Humans
KW - Neuralgia
KW - Trigeminal Neuralgia
U2 - 10.3238/arztebl.m2021.0006
DO - 10.3238/arztebl.m2021.0006
M3 - SCORING: Review article
C2 - 33827748
VL - 118
SP - 81
EP - 87
JO - DTSCH ARZTEBL INT
JF - DTSCH ARZTEBL INT
SN - 1866-0452
IS - 6
ER -