title: Diferential diagnosis in atypical facial pain: a clinical study.
abstract: OBJECTIVE
  To evaluate a sample of patients with atypical facial pain (AFP) in comparison to patients with symptomatic facial pain (SFP).
  
  
  METHODS
  41 patients with previous diagnostic of AFP were submitted to a standardized evaluation protocol, by a multidisciplinary pain team.
  
  
  RESULTS
  21 (51.2%) were considered AFP and 20 (48.8%) (SFP) received the following diagnosis: 8 (40.0%) had temporomandibular disorders (TMD); 3 (15.0%) had TMD associated to systemic disease (fibromyalgia, systemic erythematosus lupus); 4 (20.0%) had neuropathy after ear, nose and throat (ENT) surgery for petroclival tumor; 2 (10.0%) had Wallenberg syndrome; 1 (5.0%) had intracranial tumor; 1 (5.0%) had oral cancer (epidermoid carcinoma), and 1 (5.0%) had burning mouth syndrome (BMS) associated to fibromyalgia. Spontaneous descriptors of pain were not different between AFP and SFP groups (p=0.82). Allodynia was frequent in SFP (p=0.05) and emotion was the triggering factor most prevalent in AFP (p=0.06). AFP patients had more traumatic events previously to pain (p=0.001).
  
  
  CONCLUSIONS
  AFP patients had more: a) traumatic events previously to pain onset, and b) emotions as a triggering factor for pain. These data support the need of trained health professionals in multidisciplinary groups for the accurate diagnosis and treatment of these patients.
authors.affiliation: Neurological Division, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: José Cláudio Marinho
authors.initials: JC
authors.lastname: Nóbrega
authors.forename: Silvia Regina Dowgan Tesseroli de
authors.initials: SR
authors.lastname: Siqueira
authors.forename: José Tadeu Tesseroli de
authors.initials: JT
authors.lastname: Siqueira
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D002985:Clinical Protocols; D003937:Diagnosis, Differential; D005156:Facial Neuralgia / Q000175:diagnosis*; D005157:Facial Pain / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D009209:Myofascial Pain Syndromes / Q000175:diagnosis; D018710:Pain Clinics; D010147:Pain Measurement; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*; D014276:Trigeminal Nerve / Q000503:physiopathology