Lower-half facial migraine: A report of 11 cases

Pain Remapping in Migraine to the Orofacial Region

“…Our second study 2 presented a further 23 cases and proposed diagnostic criteria for orofacial migraine (or the less specific term neurovascular orofacial pain) with a calculated positive predictive value of 0.71 and a negative predictive value of 0.95. Similar case series of isolated facial or orofacial pain with neurovascular features have been reported by Daudia and Jones, 8 who presented 24 patients with maxillary pain, 11 cases by Penarrocha et al, 9 and some case reports 6,10 . We also suspected that in some of our cases the migraine may have relocated to the orofacial region, as a history of typical migraine headaches was reported by some, disappearing when the orofacial variant appeared 2 .…”

“…In our second study we also described 7 cases (30.4%) where the onset of the orofacial migraine was associated with trauma 2 . A traumatic onset, following recent dental extractions or root canal therapy, was also reported by Penarrocha et al, 9 who presented 6 of 11 cases (54.5%) with “lower half migraine” historically associated with trauma. Considering alternatives to Hussain et al's 1 proposed pathophysiology it must be remembered that migraine and neurovascular type orofacial pains have been extensively described appearing “de novo” following trauma 11‐15 .…”

“…This was spontaneous in some cases and following trauma in some, as reported by Hussain et al. An interesting finding is that the reported age of onset in orofacial migraine is from 35 9 to about 40 years old, 2,3 relatively higher than would be expected in typical migraine. This finding may support the phenomenon of “relocation” as some of our cases reported that in the past they had suffered typically located and symptomatic migraines.…”

Orofacial pain management: current perspectives

“…Migraine is commonly thought of as a headache that is unilateral and that causes pain behind the eye, neck, and cranium; however, migraine headaches can also present in the lower part of the face, particularly in the teeth 98–100. It is very important that the orofacial pain clinician is aware of the possibility of this localization in addition to the clinical features that a migraine presents to avoid misdiagnosis as an odontogenic toothache or other type of orofacial pain, leading to improper management.…”

Chronic Orofacial Pain

“…Some patients, however, present with primary lower facial pain accompanied by autonomic signs, nausea, and photo-or phonophobia [17][18][19]. These cases are often classifiable as lower cluster headache (CH) or an atypically located but otherwise classical migraine (lower half migraine).…”