Facial Pain

Facial pain occurs when facial nerves come into contact with structures such as blood vessels. It is a complex condition that requires advanced treatment from experienced specialists.

Doctors at The University of Kansas Health System have deep experience diagnosing and treating facial pain. More than simply managing symptoms, our doctors focus on addressing the underlying cause of your facial pain to improve your quality of life.

Facial pain refers to any discomfort in the face, mouth or eyes. It can range in severity from mild to severe and may have several causes. Facial pain may feel like a dull ache, throbbing, stabbing or cramp-like. When facial pain is intense, it is sometimes called "the suicide disease" because people report the chronic pain is the most severe imaginable, so severe they cannot function. Patients often report that on a scale of 1 to 10, facial pain rates a 15.

There are several types of facial pain:

• Glossopharyngeal neuralgia is a pain condition involving the back of the throat
• Nervus intermedius involves pain sensation deep within the ear
• Occipital neuralgia involves the nerves that run up the spine to the scalp
• Trigeminal neuralgia involves the 5^th cranial nerve

People with facial pain report pain that feels like a lightning bolt or lancing sensation. The pain may come on very suddenly and last for a few seconds to a minute or 2.

The pain is sometimes triggered by a recognized event, such as a bright light, a certain sound or even a breeze across the face. Even simple daily acts such as putting on makeup or brushing teeth can cause severe pain.

There is no particular risk factor for developing facial pain. Facial nerve pain can affect men and women of all ages and ethnicity.

A complete history and physical along with advanced imaging studies are used to make a facial pain diagnosis. Your doctor will diagnose your type of facial pain based on:

• Events that cause the pain
• The location of the pain
• The sharpness and sensation of the pain

To identify or rule out underlying causes, your doctor may perform different diagnostic tests:

• A neurological examination
• A physical evaluation, including touching specific areas of your face
• Magnetic resonance imaging (MRI)
• Reflex tests

Because facial pain is difficult to diagnose correctly and can be caused by many different possible conditions, your doctor may order additional tests as well. Determining an accurate diagnosis is critical to ensuring that you receive appropriate care.

The University of Kansas Health System offers a complete range of medical and surgical treatment options for face pain. We are experienced with a number of medications that can be effective.

When medications are not effective or cause too many negative side effects, we proceed to innovative surgical options:

• Craniotomy with internal neurolysis: This is similar to the decompression, but the neurosurgeon also "combs" the nerve to produce numbness that further reduces pain
• Craniotomy with microvascular decompression: A neurosurgeon moves the artery off of the nerve
• Peripheral nerve stimulation: This minimally invasive procedure uses electrodes to stimulate nerves and mask pain
• Radiofrequency rhizotomy: This outpatient procedure involves heating the nerve to stop pain
• Radiosurgery: In this procedure, a neurosurgeon removes the lesion on the nerve that is causing the pain

While these procedures may not be permanent, 90-95% of those with facial pain report they provide significant relief. It is our goal to provide the longest lasting relief possible before further treatment is necessary.