Persistent idiopathic facial pain (PIFP), formerly known as ‘atypical facial pain’, is a dull, constant, poorly localised ache in the face (most commonly the maxilla) that is not associated with any other clinical signs or pathology. It has no known cause and is therefore not a true diagnosis but rather a description. This article sets out to describe the ways in which PIFP may present in primary care, and discuss the key differential diagnoses to be excluded.
Get full access to this article
View all access options for this article.
References
1.
Aggarwal, V. R., Lovell, K., Peters, S., Javidi, H., Joughin, A., & Goldthorpe, J. (2011). Psychosocial interventions for the management of chronic orofacial pain. Cochrane Database of Systematic Reviews, 9(11), CD008456. doi: 10.1002/14651858.CD008456.pub2.
2.
AghabeigiB. B.FeinmannC. C.GloverV. V.GoodwinB. B.HannahP. P.HarrisM. M.…WasilM. (1993) Tyramine conjugation deficit in patients with chronic idiopathic temporomandibular joint and orofacial pain. Pain54(2): 159–157. doi: 10.1016/0304-3959(93)90204-3.
3.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition (p. 943). Washington, DC: American Psychiatric Association..
4.
5.
CornelissenP.Van KleefM.MekhailN.DayM.Van ZundertJ. (2009) Evidence-Based Interventional Pain Medicine According to Diagnosis. 3. Persistent Idiopathic Facial Pain. Pain Practice9(6): 443–448. doi: 10.1111/j.1533-2500.2009.00332.x.
6.
DerbyshireS. W.JonesA. K.DevaniP.FristonK. J.FeinmannC.HarrisM.…FrackowiakR. S. (1994) Cerebral responses to pain in patients with atypical facial pain measured by positron emission tomography. Journal of Neurology, Neurosurgery, and Psychiatry57(10): 1166–1172. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC485480/pdf/jnnpsyc00040-0006.pdf.
7.
Field, A., Steele, J., & Thayer, T. (2013). Facial pain: temporomandibular joint disorders. InnovAiT, 6(10), 623–628. doi: 10.1177/1755738012475063.
8.
ForssellH.TenovuoO.SilvoniemiP.JaaskelainenS. K. (2007) Differences and similarities between atypical facial pain and trigeminal neuropathic pain. Neurology69(14): 1451–1459. doi: 10.1212/01.wnl.0000277274.83301.c0.
9.
10.
KoopmanJ. S. H. A.DielemanJ. P.HuygenF. J.De MosM.MartinC. G. M.SturkenboomM. C. J. M. (2009) Incidence of facial pain in the general population. Pain147(1–3): 122–127. doi: 10.1016/j.pain.2009.08.023.
11.
LangE.KaltenhäuserM.SeidlerS.MattenklodtP.NeundörferB. (2005) Persistent idiopathic facial pain exists independent of somatosensory input from the painful region: findings from quantitative sensory functions and somatotopy of the primary somatosensory cortex. Pain118(1–2): 80–91. doi: 10.1016/j.pain.2005.07.014.
12.
ListT.LeijonG.SvenssonP. (2008) Somatosensory abnormalities in atypical odontalgia: A case-control study. Pain139(2): 333–341. doi: 10.1016/j.pain.2008.05.002.
13.
MadlandG.FeinmannC. (2001) Chronic facial pain: a multidisciplinary problem. Journal of Neurology, Neurosurgery, and Psychiatry71(6): 716–719.
14.
MuellerD.ObermannM.YoonM. S.PoitzF.HansenN.SlomkeM. A.…KatsaravaZ. (2011) Prevalence of trigeminal neuralgia and persistent idiopathic facial pain: A population-based study. Cephalalgia31(15): 1542–1548. doi: 10.1177/0333102411424619.
OkesonJ. (1996) Orofacial pain: guidelines for assessment, diagnosis, and management, New Malden, UK: Quintessence Publications.
17.
OkesonJ. P.BellW. E. (2005) Bell's orofacial pains. The clinical management of orofacial pain (p. 567), New Malden, UK: Quintessence Publications.
18.
O'Neill, F. & Rajlawat, B. (2013). Facial pain: trigeminal neuralgia. InnovAiT, 6(10), 615–622. doi: 10.1177/1755738013483279..
19.
PolycarpouN.NgY. -L.CanavanD.MolesD. R.GulabivalaK. (2005) Prevalence of persistent pain after endodontic treatment and factors affecting its occurrence in cases with complete radiographic healing. International Endodontic Journal38(3): 169–178. doi: 10.1111/j.1365-2591.2004.00923.x.
World Health Organization. (2010). The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva, Switzerland: World Health Organization.
