[Primary and atypical facial pain: diagnosis and treatment].
OBJECTIVE
Facial pain is a frequently encountered symptom in general medical practice and encompass a wide group of facial problems. As correct diagnosis can usually be reached by history and physical examination for well defined typical clinical entities (trigeminal neuralgia, cluster headache) atypical facial pain may have many other potential causes (sinuses infection, temporomandibular joint syndrome, dental disorders...) so that diagnosis not appear an easy task.


BACKGROUND
Anatomical and physiological organization of facial nociceptive system, particularly trigeminal system, may explain the variability of facial pain. Although symptoms have been clearly identified mechanism of pain production remains controversial. Several factors (psychological, neurological, endocrine...) and mechanisms (neuropathic, vascular, myoarticular) may coexist and explain trouble in diagnosing and treating facial pain.


CONCLUSIONS
Better knowledge in identifying the cause of facial pain may lead to improve patient care and avoid patient frustration, medical nomadism, repetitive dental and otolaryngologic procedures, and finally non-compliance with treatment.
Navez
M
M
Centre stéphanois de la douleur, hôpital Bellevue, CHU de Saint-Etienne, 42055 Saint-Etienne cedex 02, France. malou.navez@chu-st-etienne.fr
Créac'h
C
C
Koenig
M
M
Cathébras
P
P
Laurent
B
B
D005155:Facial Nerve Diseases / Q000175:diagnosis; D005157:Facial Pain / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008954:Models, Biological; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis; D010808:Physical Examination