Persistent idiopathic facial pain

Abstract

Background Persistent idiopathic facial pain (PIFP) is a chronic disorder recurring daily for more than two hours per day over more than three months, in the absence of clinical neurological deficit. PIFP is the current terminology for Atypical Facial Pain and is characterized by daily or near daily pain that is initially confined but may subsequently spread. Pain cannot be attributed to any pathological process, although traumatic neuropathic mechanisms are suspected. When present intraorally, PIFP has been termed 'Atypical Odontalgia', and this entity is discussed in a separate article in this special issue. PIFP is often a difficult but important differential diagnosis among chronic facial pain syndromes. Aim To summarize current knowledge on diagnostic criteria, differential diagnosis, pathophysiology and management of PIFP. Methods We present a narrative review reporting current literature and personal experience. Additionally, we discuss and differentiate the common differential diagnoses associated with PIFP including traumatic trigeminal neuropathies, regional myofascial pain, atypical neurovascular pains and atypical trigeminal neuropathic pains. Results and conclusion The underlying pathophysiology in PIFP is still enigmatic, however neuropathic mechanisms may be relevant. PIFP needs interdisciplinary collaboration to rule out and manage secondary causes, psychiatric comorbidities and other facial pain syndromes, particularly trigeminal neuralgia. Burden of disease and psychiatric comorbidity screening is recommended at an early stage of disease, and should be addressed in the management plan. Future research is needed to establish clear diagnostic criteria and treatment strategies based on clinical findings and individual pathophysiology.

Treatment of Facial Pain with I Ching Balance Acupuncture

“…1 However, atypical facial pain is not necessarily caused by TN. 2 Background persistent idiopathic facial pain (PIFP) is also a chronic disorder, recurring daily for more than 2 hours per day over more than 3 months. 2 PIFP occurs in the absence of clinical neurologic deficits.…”

“…2 Background persistent idiopathic facial pain (PIFP) is also a chronic disorder, recurring daily for more than 2 hours per day over more than 3 months. 2 PIFP occurs in the absence of clinical neurologic deficits. 2 The underlying pathophysiology in PIFP is still unknown.…”

“…2 PIFP occurs in the absence of clinical neurologic deficits. 2 The underlying pathophysiology in PIFP is still unknown. 3 Nevertheless, neuropathic mechanisms may be relevant in PIFP.…”

“…3 Nevertheless, neuropathic mechanisms may be relevant in PIFP. 2 Chronic pain is a debilitating and challenging condition for both clinicians and researchers. 4 Despite intense research, it is still not clear why some individuals develop chronic pain while others do not; nor is it clear how to heal this disease.…”

“…1 PIFP occurs in the absence of a clinically detectable neurologic deficit identified by clinical examination. 2 Epidemiologic evidence on TN, and even more so on PIFP, is quite sparse, but, generally, both TN and PIFP are believed to be rare diseases. 1 The etiology and underlying pathophysiology of TN and PIFP are still unknown 1 ; however, neuropathic mechanisms might be implicated in PIFP.…”