Atypical Facial Pain From the Neurological and Dental Perspective

Abstract

Background: Orofacial pain is related with neurogenic, vascular, collagenous and dental problems. As a syndrome, this type of pain is classified under 4 major categories; temporomandibular joint diseases, atypical facial pain (AFP), atypical odontalgia and burning mouth syndrome. Atypical facial pain, first described by Frazier and Russel, is a chronic pain syndrome on the trigeminal nerve trajectory. Objective: In this study, 12 cases of AFP are presented. Pain stimulating factors, localization, duration, severity, accompanying symptoms, orodental findings, treatment and response are evaluated.Findings: A total of twelve cases, 8 female and 4 male were evaluated. Mean age was 41.3. Duration of pain was different for all patients (2-35 years), Frequency, localization and severity of pain were as the fallowing: Frequency: everyday in 10 cases (%83.3); 2-7 times per week (mean, 3) in other cases. Localization: unilateral in 11 cases, bilateral in one case. Severity: between 5 and 8 according to VAS in all cases (mean; 6.8). Neurologic, orodental and radiological examinations revealed no positive findings of AFP. In 9 cases, mild or moderate depression was detected based on Hamilton Depression Scale. Antidepressants and antiepileptic agents were administered for treatment inall patients. lmprovement in nine patients were appreciated. Conclusion: At the end of 23 months of follow-up period, we concluded that a multidiciplinary evaluation and relatively long fallow-up period is necessary in the diagnosis and management of AFP cases as in other chronic pain syndromes.