General Medical Information

Facial Pain

Frank E. Lucente
Samir Shah
Roger Kula

Sinusitis is a common cause of facial pain and headache. Trigeminal neuralgia, usually induced by palpation of a trigger zone, causes severe pain. Sphenopalatine neuralgia (Sluder syndrome) is localized facial pain associated with vasomotor abnormality, such as lacrimation, rhinorrhea, and salivation. The pain involves the eye, nose, palate, maxillary teeth, ear, and temple. Glossopharyngeal neuralgia involves unilateral throat pain associated with ipsilateral rhinorrhea, salivation, coughing, and facial burning. Postherpetic neuralgia is similar to trigeminal neuralgia. It occurs after attacks of herpes zoster. Trotter syndrome involves pain in the mandibular division of cranial nerve V, unilateral deafness, ipsilateral palate hypomotility, and trismus. Ramsay Hunt syndrome is caused by herpes zoster infection of the geniculate ganglion. Signs are vesicles on the ear, oral mucosa, tonsils, pharyngeal mucosa, and posterior third of the tongue; facial palsy; loss of taste; decreased salivation; palatal paralysis; and pain. Eagle syndrome is caused by elongation and calcification of the styloid process along with calcification of the stylohyoid ligament. Symptoms are parapharyngeal pain, dysphagia, odynophagia, trismus, headache, and facial pain. Vail syndrome, vidian nerve neuralgia, causes unilateral pain of the nose, eye, face, neck, and shoulder.