If you suffer from atypical facial pain (also referred to as persistent idiopathic facial pain or PFIP), you are familiar with the unbearable symptoms that present in the form of intense and unpleasant sensations on one side of your face. How many times have you found yourself staying home in agony, instead of going out and enjoying your life? While there is no true atypical facial pain cure, advances in diagnostics and numerous treatment options mean you don’t have to suffer with the pain and discomfort of this condition any longer.
What Is Atypical Facial Pain?
Atypical facial pain is a complicated condition to define. It usually does not have a central cause; in many cases the trigeminal nerve has been injured or impinged, or demyelination (loss of the outer nerve sheath) can lead to the manifestation of symptoms. Other causes include dental issues, temporomandibular joint dysfunction (TMJ), sinus problems or other facial nerve irritation.
What Are the Symptoms?
Atypical facial pain presents differently in each individual. The one constant in all cases is that it manifests as pain in the face. It typically happens on only one side, is intense and can persist for the entire length of the day.
Some of the words that have been used by atypical facial pain sufferers to describe their facial pain symptoms have included: crushing, squeezing, sharp, intense, unyielding, pulsing, aching, dull, stabbing… the list goes on. Your atypical facial pain may make itself known with only one sensation, or a myriad of debilitating sensations.
Interestingly, despite the intense symptoms it creates, atypical facial pain does not appear in lab or imaging studies, making it sometimes elusive to diagnose. It can occur in an otherwise completely healthy individual and have no impact on the sufferer’s overall physical health.
Treatments for Atypical Facial Pain
While there is no definitive atypical facial pain cure, there are many treatment options available to those who suffer from this condition. The first course of action is usually drug intervention using one or more drugs to control the pain and nerve response. Your doctors will work together to find the best drug options for you and they can also determine if you might need more than one type of drug.
Through a great deal of research and clinical use, antidepressants have been found to be quite effective in the treatment of atypical facial pain – especially those in the selective serotonin reuptake inhibitor (SSRI), norepinephrine reuptake inhibitors (NeRI) and tricyclic antidepressants (TCA) families. Many people also find some level of relief from anticonvulsants. Narcotics are used sparingly, as they typically are not as effective, and they also have addictive properties, unlike antidepressants and anticonvulsants.
If pharmaceutical treatment options for atypical facial pain have failed to bring the desired level of relief, or other issues such as side effects become unbearable, surgery should be the next consideration. Luckily, there are numerous surgical options that will give you freedom from the pain and discomfort of this condition.
The available and effective surgical options include:
- Microvascular decompression surgery: A highly effective surgery where your neurosurgeon will create a small window in your skull via an incision in your scalp. The portion of your skull that will be removed is approximately the size of a quarter. Your trigeminal nerve will then be isolated and the offending vessel identified. Then your surgeon will carefully lift the artery or vein and place a tiny Teflon pad between the two structures to prevent further irritation of the trigeminal nerve.
- Gamma Knife Radiosurgery: A non-invasive procedure, Gamma Knife Radiosurgery isn’t surgery in the traditional sense. Rather than creating an opening in your skull, a highly concentrated series of around 200 tiny radiation beams are focused on the area of the trigeminal nerve believed to be causing the pain. The beauty of Gamma Knife Radiosurgery is the minimal effects it has on surrounding structures. Only where the beams meet will the radiation be strong enough to elicit a change in the tissue. This radiation will create minimal damage to the offending area of the nerve, dampening nerve impulses and thus, the associated pain.
- Percutaneous rhizotomy: Using a long, hollow needle, your neurosurgeon will introduce a tiny electrode into the damaged area of your trigeminal nerve. The electrode is then used to essentially cauterize and “numb” that portion of the nerve, decreasing the stimulation from the nerve impulses.
- Pain stimulator implant: Typically the last choice, in the event that other options have failed or have been determined inappropriate, a pain stimulator implant will be considered. This procedure involves guiding a tiny electrode to or near the trigeminal nerve. The stimulator can help decrease nerve pain signals via electro stimulation, allowing you to gain relief from the constant, agonizing discomfort of your atypical facial pain.
Regardless of the route you choose, it’s important to weigh all of your atypical facial pain cure options. Don’t hesitate to ask your doctor for more information on any of the above treatments. They can help guide you to the best solution for your atypical facial pain and assist you in receiving the latest in facial pain treatment.
