Causes and types of facial Pain
Facial pain could be secondary to an array of diseases. For instance, pain in paranasal sinuses is one of the common causes of facial pain. Clinical examination and history of the patient aid in diagnosing the true cause of the pain. Temporal profile and pain origin are two important factors taken into account for the diagnosis. Based on these factors, facial pain could be divided into four categories: chronic, episodic, progressive and sudden.
Chronic
Chronic pain is benign facial pain. Chronic sinusitis, chronic tension and analgesic abuse headaches, giant cell arteritis and symptomatic trigeminal neuralgia may cause the pain.
Episodic
Episodic pain is also benign facial pain. The following disorders may cause the episodic pain:
- Arteriovenous malformation
- Chiari malformation
- Classic trigeminal neuralgia
- Cluster, exercise, post-coital and tension headaches
- CSF hypotension
- Migraine
- Occipital neuralgia
- Subacute angle closure glaucoma
- Systemic hypertension
- Third ventricle tumor
Progressive
Different diseases can lead to progressive pain, an intracranial process. For instance, abscess, chronic fever, chronic meningitis, idiopathic intracranial hypertension, subdural hematoma and tumor.
Sudden
Source of sudden pain includes the following:
- Acute angle closure glaucoma
- Acute obstructive hydrocephalus
- Acute sinusitis may cause pain-sinus.
- Cerebral infarction
- Encephalitis
- Fever
- Intracranial hemorrhage
- Meningitis
- Pituitary apoplexy
- Severe systemic hypertension
- Subarachnoid hemorrhage
- Thunderclap headache
Facial pain could be direct via the structures of the face or referred pain originating in surrounding structures. Pain-sinus may cause pain in the facial area because sinuses are located within the area. A sizeable number of patients who have undergone endoscopic sinus surgery complain about facial pain.
Headaches secondary to paranasal sinus problems are surrounded by several controversies and different terms are used to describe these headaches. For example, these headaches are called sinogenic facial pain, rhinosinusitis headache and sinus headache. Stress and psychological factors also contribute to the pain.
Analysis of facial pain
For a thorough understanding of the facial pain, including that of pain-sinus, analysis of the following is necessary:
- Therapies used and their result
- Signs and symptoms related to pain
- Prodromes, symptoms before onset of the pain
- Factors that precipitate the pain
- Temporal profile: worsening of the pain in recent past and age at which pain started
- Duration and frequency of the pain episodes
- Level of pain
- Pain types: throbbing, constant or dull
- Side of pain: bilateral, unilateral, alternating
- Pain location
