facial pain
see also:
ophthalmology
faciomaxillary
Introduction
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