title: Atypical Facial Pain: a Comprehensive, Evidence-Based Review.
abstract: OBJECTIVE
  The purpose of this article is to focus on an excruciating disorder of the face, named atypical facial pain or persistent idiopathic facial pain (PIFP). It is considered an underdiagnosed condition with limited treatment options. Facial pain can be a debilitating disorder that affects patients' quality of life. Up to 26% of the general population has suffered from facial pain at some point in their lives. It is important to highlight the different types of facial pain to be able to properly manage this condition accordingly.
  
  
  RESULTS
  Newer interventional modalities such as pulsed radiofrequency ablation (PFR) of the sphenopalatine ganglion, peripheral nerve field stimulators (PNFS), and botulinum toxin injections have promising results. In summary, more prospective studies such as randomized controlled trials are necessary to explore the possibility of their more widespread use as viable procedures for the treatment of PIFP. In this review article, we describe the workup and diagnosis of PIFP and highlight recent literature regarding the pathophysiology and treatment of PIFP. PIFP is an excruciating disorder of the face often misdiagnosed as trigeminal neuralgia (TN) However, unlike TN symptoms, the pain is persistent rather than intermittent, usually unilateral, and without autonomic signs or symptoms. When a clinician encounters a patient with neuropathic facial pain whose symptoms are incongruent with the more common etiologies, the diagnosis of atypical facial pain must be entertained. Treatment of PIFP is multidisciplinary. Unfortunately, few randomized controlled trials for the treatment of PIFP exist. However, there are a select number of pharmacological, non-pharmacological, and interventional treatment options that have proven to be moderately effective.
authors.affiliation: Anesthesiology Department, Louisiana State University Health Science Center, New Orleans, LA, USA.
authors.forename: Austin L
authors.initials: AL
authors.lastname: Weiss
authors.affiliation: Anesthesiology Department, Louisiana State University Health Science Center, New Orleans, LA, USA.
authors.forename: Ken P
authors.initials: KP
authors.lastname: Ehrhardt
authors.affiliation: Pain Management Center, Anesthesiology Department, Ochsner Health System, New Orleans, LA, USA. rtolba@ochsner.org.|, 200 West Esplanade Avenue, Suite 702, Kenner, LA, 70065, USA. rtolba@ochsner.org.
authors.forename: Reda
authors.initials: R
authors.lastname: Tolba
mesh_terms: D019317:Evidence-Based Medicine; D005157:Facial Pain / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans
keywords: Cranial neuralgias; Facial pain; Orofacial pain; Persistent idiopathic facial pain (PIFP); Trigeminal neuralgia