ATYPICAL FACE PAIN; A STATISTICAL CONSIDERATION OF 66 CASES

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Abstract
A statistical analysis of 66 consecutive cases encountered in 6 yrs. was presented. The ratio of female] [female] to [male][male] was approx. 2:1. The avg. age of patients at the onset of pain was 33.3 yrs. and the avg. duration was 7 yrs. The left side of the face was involved slightly more often than the right which was probably of no statistical significance. The distribution of the distress was widespread on the affected side. The descriptive terms used by the patients were mentioned and the concept that the sensation was a deep, dull, almost constant ache, often throbbing, was obtained. Twenty-eight patients had essentially constant distress. A significant number of dental operations, operations on the nose and paranasal sinuses and needless neurologic surgical procedures had been performed. A wide variety of agents and medications improvised by the patients or suggested by physicians elsewhere provided some relief and a similarly wide variety of factors accentuated the distress. Twenty-eight patients presented symptoms, in addition to the pain, which were highly suggestive of the presence of a vascular factor. These comprise about 42% of the patients studied, a figure in substantial agreement with that given by Glaser for a much larger series. The condition of 30 of 46 [female] [female] (approx. 65%) and of 7 of the 20 [male] [male] (35%) was thought to have a significant functional element. Only 9 patients obtained any significant relief and but 3 of these were relieved completely. The procedures which offered such relief were tabulated. A total listing of the prepns. and procedures attempted in the section was given. The impression was obtained that the patients who had the most significant degree of vascular sym-toms (that is, phenomena associated with the sympathetic nervous system) were more likely to obtain relief with treatment such as histamine desensitization or the use of vasoconstrictor medications. Study of this small series permits no conclusions. This communication serves only to re-emphasize the difficulties in diagnosis and treatment and to contribute information concerning the condition.

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