Login

Facial Pain

 

Trigeminal neuralgia:

 

  • paroxysmal episodes of unilateral facial pain lasting < 2 minutes
  • pain with ;
    • distribution along one or more branches of the trigeminal nerve
    • sudden, intense, sharp in quality
    • severe in intensity
    • precipitated by trigger zones or certain daily activities e.g. cold
    • absence of symptoms between paroxysms 
  • there is no neurological deficit 

 Exclude dental, parotid, ENT, Rheumatological cause.

Trial of Treatment e.g. amitryptiline, gabapentin, carbemazepine,lamotrigine or baclofen is desirable but not critical before Neurology referral. 

Other causes include migraine variants, meningeal lesions, brain stem lesions, and atypical facial.

Referral:

ENT referral for parotid/obvious ENT cause of pain.

Dental for dental cause

Cranial Arteritis: Rheumatology

Others: Neurology