Lower-half facial migraine: a report of 11 cases.
OBJECTIVE
Vascular pain of the face constitutes a variant of pain of the head, and includes migraine, cluster headache, paroxysmal hemicrania, and a facial variant of the so-called lower-half migraine. Lower-half facial migraine is a condition difficult to classify; according to the international classifications it could not be found as an individual entity. The objective of the present study is to determine the difficulties we encountered in diagnosis, the ineffective treatments provided, and the pharmacologic treatment effect.


METHODS
A study is made of 11 cases of lower-half facial migraine, corresponding to 10 women and 1 man (mean age, 35 years), commenting on the clinical characteristics of the disorder and its treatment options. The location of the pain often mimics dental pain, and can lead to a mistaken diagnosis and to the application of inappropriate therapeutic measures. Forty-five percent of the patients had a history of endodontic treatment before the development of pain in the initially affected quadrant. Once the pain had developed, extractions were carried out in 36% of cases in an unsuccessful attempt to secure symptom relief. Our pharmacologic treatment consisted of ergotamine in 9 cases and the remaining 2 patients received indomethacin.


RESULTS
Nine patients (82%) improved as a result of treatment, with an important reduction in the frequency of the pain episodes and intensity of pain. One patient failed to respond to ergotamine, while another patient failed to improve with indomethacin. Both were prescribed only minor analgesics.


CONCLUSIONS
The treatment of migraine occurring in the face is no different than that provided for pain occurring in the head.
Peñarrocha
Miguel
M
School of Dentistry, University of Valencia, Spain. Miguel.penarrocha@uv.es
Bandrés
Alicia
A
Peñarrocha
María
M
Bagán
Jose Vicente
JV
D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004878:Ergotamine / Q000627:therapeutic use; D005157:Facial Pain / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D008881:Migraine Disorders / Q000145:classification* / Q000175:diagnosis* / Q000628:therapy; D012390:Root Canal Therapy; D014081:Tooth Extraction
D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004878:Ergotamine; D007213:Indomethacin