Orofacial Migraine and Other Idiopathic Non-Dental Facial Pain Syndromes: A Clinical Survey of a Social Orofacial Patient Group

Federica Reina, Giuseppe Salemi, Mariarita Capizzi, Salvatore Lo Cascio, Antonio Marino, Giuseppe Santangelo, Andrea Santangelo, Mirko Mineri, Filippo Brighina, Vincenzo Raieli () and Carmelo Attilio Costa
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Federica Reina: Child Neuropsychiatry Unit Department, Pro.M.I.S.E. “G D’Alessandro”, University of Palermo, 90100 Palermo, Italy
Giuseppe Salemi: Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, 90100 Palermo, Italy
Mariarita Capizzi: Child Neuropsychiatry Unit Department, Pro.M.I.S.E. “G D’Alessandro”, University of Palermo, 90100 Palermo, Italy
Salvatore Lo Cascio: Child Neuropsychiatry Unit Department, Pro.M.I.S.E. “G D’Alessandro”, University of Palermo, 90100 Palermo, Italy
Antonio Marino: Child Neuropsychiatry Unit Department, Pro.M.I.S.E. “G D’Alessandro”, University of Palermo, 90100 Palermo, Italy
Giuseppe Santangelo: Child Neuropsychiatry Department, ISMEP—ARNAS Civico Palermo, via dei Benedettini 1, 90100 Palermo, Italy
Andrea Santangelo: Pediatric Neurology, Pediatric Department, AOUP Santa Chiara Hospital, 56121 Pisa, Italy
Mirko Mineri: Pain Management Department, Humanitas, 95045 Catania, Italy
Filippo Brighina: Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, 90100 Palermo, Italy
Vincenzo Raieli: Child Neuropsychiatry Department, ISMEP—ARNAS Civico Palermo, via dei Benedettini 1, 90100 Palermo, Italy
Carmelo Attilio Costa: Pain Management Department, Humanitas, 95045 Catania, Italy

IJERPH, 2023, vol. 20, issue 20, 1-14

Abstract: Background : Orofacial pain syndromes (OFPs) are a heterogeneous group of syndromes mainly characterized by painful attacks localized in facial and oral structures. According to the International Classification of Orofacial Pain (ICOP), the last three groups (non-dental facial pain, NDFP) are cranial neuralgias, facial pain syndromes resembling primary headache syndromes, and idiopathic orofacial pain. These are often clinical challenges because the symptoms may be similar or common among different disorders. The diagnostic efforts often induce a complex diagnostic algorithm and lead to several imaging studies or specialized tests, which are not always necessary. The aim of this study was to describe the encountered difficulties by these patients during the diagnostic–therapeutic course. Methods : This study was based on the responses to a survey questionnaire, administered to an Italian Facebook Orofacial Patient Group, searching for pain characteristics and diagnostic–therapeutic care courses. The questionnaire was filled out by patients affected by orofacial pain, who were 18 years and older, using a free online tool available on tablets, smartphones, and computers. Results : The sample was composed of 320 subjects (244F/76M), subdivided by age range (18–35 ys: 17.2%; 36–55 ys: 55.0%; >55 ys 27.8%). Most of the patients were affected by OFP for more than 3 years The sample presented one OFP diagnosis in 60% of cases, more than one in 36.2% of cases, and 3.8% not classified. Trigeminal neuralgia is more represented, followed by cluster headaches and migraines. About 70% had no pain remission, showing persisting background pain (VAS median = 7); autonomic cranial signs during a pain attack ranged between 45 and 65%. About 70% of the subjects consulted at least two different specialists. Almost all received drug treatment, about 25% received four to nine drug treatments, 40% remained unsatisfied, and almost 50% received no pharmacological treatment, together with drug therapy. Conclusion : To the authors’ knowledge, this is the first study on an OFP population not selected by a third-level specialized center. The authors believe this represents a realistic perspective of what orofacial pain subjects suffer during their diagnostic–therapeutic course and the medical approach often results in unsatisfactory outcomes.

Keywords: orofacial pain syndrome; non-dental facial pain; headache; migraine; trigeminal neuralgia; cluster headache (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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