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Woman holding cold compress to her face, appearing in pain or discomfort

FACIAL PAIN & NEUROPATHIC HEADACHES

Facial pain can be intense, confusing, and difficult to diagnose. While some types are linked to migraine, others fall under nerve-related or central pain disorders. This page brings together rare and overlapping facial pain syndromes that previously had their own listings on the legacy iMigraine site. These include trigeminal neuralgia, occipital pain syndromes, cranial nerve disorders, and neuropathic facial pain conditions.

TRIGEMINAL NEURALGIA

(TIC DOULOUREUX)

 

Trigeminal neuralgia is a severe, stabbing facial pain condition affecting one or more branches of the trigeminal nerve. It usually presents as shock-like pain triggered by chewing, talking, or light touch. The condition can be caused by vascular compression, tumors, multiple sclerosis, or idiopathic origins.

It often begins in adulthood and may affect one side of the face. Pain episodes can be brief and repetitive. Full neurologic and imaging workup is often needed to rule out secondary causes.

GLOSSOPHARYNGEAL NEURALGIA (GPN)

 

A rare nerve condition involving stabbing pain in the throat, jaw, or ear, triggered by coughing or swallowing. Although rare, it may be confused with dental or throat issues. GPN often responds to carbamazepine and may occasionally require nerve decompression surgery.

OCCIPITAL NEURALGIA

 

Pain that radiates from the upper neck into the scalp, often described as sharp or electric. Causes include muscle tension, spine abnormalities, or irritation of the greater or lesser occipital nerves. It may overlap with migraine but is typically more localized. Diagnosis can include nerve blocks.

ATYPICAL & NEUROPATHIC FACIAL PAIN

 

These include post-traumatic facial pain, Ramsay Hunt syndrome, and other difficult-to-classify conditions where the pain doesn’t follow a clear nerve pattern. Some may stem from prior injury, nerve damage, or post-infection syndromes. Symptoms may include burning, tingling, or aching.

CLUSTER-TIC SYNDROME

 

An overlap of trigeminal neuralgia and cluster headache features. These attacks present as short, stabbing pain near the eye or temple with autonomic symptoms like tearing or nasal congestion. They may appear in clusters, mimicking other TACs (trigeminal autonomic cephalalgias).

SUNCT SYNDROME

 

Short-lasting Unilateral Neuralgiform Headache with Conjunctival injection and Tearing. A rare condition with repeated episodes of severe pain near one eye, with associated redness and tearing. Most common in men. Distinct from cluster headache by duration and frequency of attacks.

RAEDER'S PARATRIGEMINAL NEURALGIA

 

Combines facial pain with oculosympathetic symptoms like ptosis (drooping eyelid) and miosis (pupil constriction). May be linked to lesions near the carotid artery. Presents without clear cranial nerve damage and may be mistaken for migraine variants.

CENTRAL CAUSES OF FACIAL PAIN

 

This includes pain stemming from thalamic lesions, anaesthesia dolorosa (following surgical nerve damage), and brainstem injury. These conditions can result in persistent pain with no obvious structural findings on imaging. Some patients experience daily facial pain without sensory loss.

FACIAL DYSESTHESIA & ITCHING

 

Neuropathic sensations such as itching, tingling, or burning on the face can appear in trigeminal neuropathies or following shingles (postherpetic neuralgia). These symptoms are often underreported and may not correlate with imaging.

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RELATED HEADACHE TYPES

 

Several other conditions overlap with facial pain, including:

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While these aren't always classified as migraine variants, they can present in similar ways and may require neurological input.

DISCLAIMER

The information provided on this page is intended for educational purposes only and does not substitute professional medical advice. Always consult your healthcare provider for a proper diagnosis and treatment plan.

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