Facial Involvement in Primary Headaches Occurs Infrequently

Facial involvement in primary headaches occurs infrequently, according to a study published online Aug. 21 in Neurology.

Christian Ziegeler, M.D., and Arne May, M.D., Ph.D., from the University Medical Center Hamburg-Eppendorf in Germany, and colleagues examined the prevalence of facial pain presentations among 2,912 patients with primary headaches between 2010 and 2018.

The researchers found that 291 patients reported facial pain as an independent or additional symptom. Overall, 2.3 percent of the 1,935 patients with migraine reported facial involvement, most commonly in the second trigeminal branch (maxillary zone); 40.9 percent of these patients experienced the pain mainly in the face. Facial involvement was reported by 14.8 percent of the 283 patients with cluster headache; 31.0 percent perceived the pain predominantly in the face. Overall, facial involvement was reported in 45.0, 21.4, and 20.0 percent, respectively, of patients with paroxysmal hemicrania, hemicrania continua, and short-lasting neuralgiform headache attacks with conjunctival injection and tearing/short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms. Six patients were presented who reported constant side-locked facial pain with superseded well-defined facial pain attacks several times per day.

"For a better understanding of these types of facial pain and ultimately for the development of treatments, it's crucial that we understand more about facial pain and whether it is the same disease as the headache, but showing up in a different place, or whether they are two different syndromes," May said in a statement.

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