Facial pain: clinical analysis
Azimova Yu.E., Skorobogatykh K.V.

University Headache Clinic, Moscow

 Persistent idiopathic facial pain (PIFP) is defined as an ongoing facial pain that does not have the characteristics of cranial neuralgia and is not associated with other causes. This form of facial pain is considered today as a polyethological syndrome, which includes a myogenic or iatrogenic source of peripheral sensitization in the face area, insufficiency of the central analgesic systems, and the presence of comorbid emotional affective disorders. PIFP is one of the least diagnosed causes of orofacial pain and a difficult-to-cure disease in clinical practice. PIFP is an interdisciplinary problem, because patients with prosopalgia apply to doctors of various specialties. It is extremely important at the primary stage of patient management to exclude the secondary nature of prosopalgia. This article examines the criteria of the PIFP, the main complaints of patients, the features of the clinical course, differential diagnosis and the most important approaches to treatment. Two clinical cases are described.
PIFP is one of the most therapy resistant chronic pain syndromes. The greatest effect is achieved by a multidisciplinary approach using a combined pharmacotherapy with antidepressants and anticonvulsants with analgesic effect and non-drug therapy.

Key words: persistent idiopathic facial pain, prosopalgia, atypical facial pain, antidepressants, anticonvulsants.
For citation: Azimova Yu.E., Skorobogatykh K.V. Facial pain: clinical analysis // RMJ. 2017. № 24. P. 1764–1766.