What Is Atypical Facial Pain?

Atypical facial pain is also called persistent idiopathic facial pain or atypical facial neuralgia. This headache condition refers to pain in the trigeminal nerve region. As the largest of all cranial nerves, the trigeminal nerve provides sensations to the face, mucous membranes and other neighboring structures.

Atypical facial pain symptoms may include:

  • Pain in the trigeminal nerve region that is continuous or lasts for most of the day
  • Pain that is unilateral (one-sided)
  • Pain that is described as deep, aching, burning or crushing
  • Pain that is confined to the facial area and remains on one side of the face
  • Pain that is not associated with sensory loss or other physical signs
  • Pain that can be similar to tension-type headaches
  • Symptoms such as depression, anxiety and hypochondria
  • Sleep disturbances and/or insomnia

An atypical facial pain diagnosis is usually made if an individual’s facial pain can’t be classified as belonging to other types of neuralgia. For instance, trigger areas that are associated with trigeminal neuralgia are usually absent in patients with this condition. Medical examinations or workups report no abnormalities in individuals.  For this reason, the condition is seen in the medical community as a challenge to identify and treat, and patients are often misdiagnosed.


Atypical facial pain causes are unknown. Patients will often associate their pain to a prior accident or surgery. Sometimes stress is said to contribute to the development of the condition, while some research suggests it is an early form of trigeminal neuralgia. In some cases, patients go through a traumatic life event before starting to experience atypical facial pain. Other causes can include a medical history of facial trauma, injury in the trigeminal nerve proximally or distally, infection, or a tumor in the head or neck. However, in the majority of cases, physical workups, laboratory tests and imaging studies don’t reveal anything out of the ordinary.

There is a strong correlation between atypical facial pain and psychological factors. Most patients suffer from depression, anxiety or hypochondria, or report being affected by other chronic pain conditions. These psychological factors could either cause or contribute to the development of the pain. Other theories suggest that the psychological conditions could be the consequences of suffering from a chronic condition that causes constant pain and is not well understood in the medical community.

Atypical Facial Pain Treatment

An atypical facial pain cure does not exist. Treatment revolves around relieving the symptoms of the condition, which are different for each individual. Due to the unknown causes and the various aspects of atypical facial pain, a multidisciplinary approach works best to address all signs and symptoms of the condition.

If you’ve been diagnosed with this condition, your physician may start with pharmacological therapy, including IV infusions if your case is severe, and recommend analgesics, antidepressants, muscle relaxants or anticonvulsants.

To address psychological overlay, a treatment plan that involves psychological intervention (such as cognitive behavioral therapy) is recommended. Physical and recreational therapy can help you adopt a healthier lifestyle including activities that can reduce both physical and psychological tension.

Biofeedback could increase your stress awareness and teach you how to return to a calmer state of mind. Acupuncture has also been successfully used to reduce chronic pain and anxiety, while massage therapy can be used for relaxation and to reduce muscle tension and pain. Depending on your specific case, nerve blocks in the trigeminal nerve region could provide relief for symptoms of atypical facial pain.



Atypical Facial Pain