What causes central and idiopathic facial pain and headache?

Updated: Jan 29, 2020
  • Author: Tejas Raval, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Two main idiopathic disorders that cause headache and facial pain are midfacial segment pain and atypical facial pain. [38]

Midfacial segment pain

This is a form of tension-type headache of the midface. Pain is a symmetric pressure sensation in the nasion, nasal dorsum, periorbital, or malar region. Hyperesthesia of the skin and soft tissues is also found. Treatment consists of low-dose amitriptyline at 10 mg for 6 months, which may take up to 6 weeks to show effect. [39, 40]

Atypical facial pain

This is also known as persistent idiopathic facial pain, as classified by the International Headache Society (IHS). The pain is constant, deep, and ill defined, usually crossing recognized dermatomes. The distribution is often unilateral. It occurs most commonly in women older than 40 years. The pain may alter in location, and psychological factors may play a role. The treatment is similar to that for midfacial segment pain. [41]

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