Facial pain III. A prospective study of the localization of facial pain in 1052 patients

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Abstract
The study is based on 1052 prospective patients. They have been divided into 3 groups according to the duration of the attack. The purpose of this study is to evaluate the importance of localization of the pain in order to determine its patho-anatomical basis. The right/left ratio was 2/1 in the Neuralgia Patients. There was no difference in patients with Non-neuralgiform Pain. There were extremely few cases of bilateral pain among the Neuralgia Patients, 15% among patients with Non-neuralgiform Pain. In the Neuralgia Patients there was a predominantly deep localization up to 50%, the Non-neuralgiform Pain 74%. Seventeen points of origin of pain have been registered in the face. By far the most frequent is a point of origin with radiation. If the percentage distribution is calculated according to each trigeminal division, the point of origin of pain in 74% is the eyebrow in the area of the 1st division, as regards the 2nd and 3rd divisions more than 30% from the upper gingiva, the area in front of the ear and the lower gingiva and between 11 and 20% from the forehead and the hairline, the upper lip and the nasolabial sulcus, the maxilla and the cheek. Pain radiation is generally most frequent to the division from which the pain originates. Neuralgia hardly radiates outside the boundaries of the face. The pain is localized within the area of one division in 42%. The radiation is not systematic. It is not possible from the localization of the pain to decide any patho-anatomical basis of the pain. Nothing in the localization of pain can be used for classification of facial pain (particularly not the “parallelism” or the “peripheral course”).