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Persistent Idiopathic Facial Pain

Background

Persistent idiopathic facial pain (PIFP), originally known as atypical facial pain, refers to pain along the territory of the trigeminal nerve that does not fit the classic presentation of other cranial neuralgias.
The pain is usually of long duration, lasting most of the day (if not continuous), is unilateral, and is without autonomic signs or symptoms. It is described as a severe ache, crushing sensation, or burning sensation. Upon examination and workup, no abnormality is noted.

Within the group of chronic facial pain syndromes, PIFP represents a particular diagnostic challenge. Patients frequently are misdiagnosed or attribute their pain to a prior event, such as a dental procedure or facial trauma. Psychiatric symptoms of depression and anxiety are prevalent in this population, further compounding the diagnostic conundrum. Treatment of PIFP is typically less effective than that of other facial pain syndromes, and a multidisciplinary approach is required to address the many facets of this pain syndrome.

For patient education resources, see the Brain and Nervous System Center, as well as Trigeminal Neuralgia (Facial Nerve Pain).

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