Persistent idiopathic facial pain: a difficult path to a complex diagnosis
Parkhomenko E.V.¹, Nartov S.E.², Karpov D.Yu.<sup>1,2

1</sup> Altai State Medical University, Barnaul
² LLC «Karpov’s Neuroclinic», Barnaul

The presented literature review provides data on prevalence, classification, pathogenesis, clinical picture, diagnosis and treatment of persistent idiopathic facial pain (PIFP). Possible pathogenetic mechanisms of this disease are discussed. The authors emphasize the dysfunctional character of the pain syndrome and high comorbidity with mental disorders. Particular attention is paid to differential diagnosis of PIFP with trigeminal neuralgia, migraine, trigeminal vegetative cephalalgia, facial myofascial pain. The article highlights the importance of the multidisciplinary approach at the stage of differential diagnosis of the PIFP, the interaction of various specialists (neurologists, dentists, otolaryngologists, maxillofacial surgeons, psychiatrists) for excluding the profile pathology. The article provides information on the management of patients with PIFP in accordance with modern world views on the pathogenesis and treatment of this disease. Information on the effectiveness of some pharmacological drugs and non-drug therapies (laser therapy, transcranial magnetic stimulation of the brain, methods based on biofeedback, virtual reality) are presented. Methods of psychotherapy (cognitive-behavioral therapy, hypnosis) can also be useful in PIFP.

Key words: persistent idiopathic facial pain (PIFP), atypical facial pain, trigeminal neuralgia, myofascial pain, neuropathy, depression, diagnosis, classification of facial pains, differential diagnosis, treatment. 
For citation: Parkhomenko E.V., Nartov S.E., Karpov D.Yu. Persistent idiopathic facial pain: a difficult path to a complex diagnosis // RMJ. 2017. № 24. P. 1738–1744.