facial pain

see also:

• ophthalmology
• faciomaxillary

• most non-traumatic causes of facial pain have a clear tender focus or skin abnormality which may point to conditions such as:
  • sinusitis
  • odontogenic sinusitis
  • Periorbital and orbital cellulitis
  • cellulitis
  • skin abscess
  • dental abscess
  • acute dental pain / dental abscess
  • eye conditions
  • ear pain
  • herpes zoster (shingles)
  • mumps
  • TMJ pain
  • Ludwig's angina - floor of mouth infection - acute swollen floor of mouth / bull neck
  • iatrogenic post-injection “post-traumatic neuropathy”
  • rarely neoplasia
• other conditions are less clear by examination alone and include:
  • migraine, especially upper C1-2 facet joint triggered cervicogenic migraines - often causing unilateral retro-orbital or facial pains
  • cluster headaches
  • giant cell temporal arteritis
  • trigeminal neuralgia
    • TN1 is characterized by intensely sharp, throbbing, sporadic, burning or shock-like pain around the eyes, lips, nose, jaw, forehead and scalp
    • TN2 pain often is present as a constant, burning, aching
    • in younger patients in particular it can be due to:
      • multiple sclerosis (MS)
      • acoustic neuroma
      • rarely, other neural tumours such as:
        • schwannoma
          • may be genetic - neurofibromatosis type 2 (NF2), schwannomatosis (2.4-5% of patients with a schwannoma), and Carney Complex
  • trigeminal neuropathic pain (TNP)
    • constant, dull and burning but can have triggered sharp pains
  • trigeminal autonomic cephalalgia (TAC)]
  • temporal tendinitis
  • Ernest syndrome (injury of the stylomandibular ligament)
  • occipital neuralgia
  • post-herpetic neuralgia
  • glossopharyngeal neuralgia
    • acute intense attacks of extreme pain in the back of the throat, tongue or ear
  • referred pain to jaw:
    • gastro-oesophageal reflux
    • acute coronary syndromes
    • aortic dissection