Idiopathic Facial Pain Diagnosis and Treatment

Diagnosis Criteria

The diagnosis of persistent idiopathic facial pain (PIFP) is made by excluding other known causes of facial pain, and is often characterized by a history of other chronic pains, poor coping strategies, and mood disorders, according to the British Journal of Anaesthesia 1

The primary treatment strategy for persistent idiopathic facial pain is a combination of antidepressants and cognitive behavioral therapy, as recommended by the British Journal of Anaesthesia 1, 2, 3
Antidepressants, such as tricyclic antidepressants (e.g. amitriptylin), are considered the primary treatment option, with venlafaxin and fluoxetin also being considered, based on guidelines from the British Journal of Anaesthesia 5
Cognitive behavioral therapy is a crucial component of treatment, often used in combination with antidepressants, to help manage chronic pain and improve quality of life, as suggested by the British Journal of Anaesthesia 1, 3
The British Journal of Anaesthesia recommends considering differential diagnoses, such as giant cell arteritis, which must be excluded in patients over 50 years old with temporal area pain, and trigeminal neuralgia, which is characterized by short, stabbing pain attacks, 1, 5
The American College of Neurology is not mentioned in this article, however the British Journal of Anaesthesia suggests that trigeminal autonomic cephalalgias can be mistaken for unilateral autonomic symptoms 2, 3