Diagnosing Atypical Facial Pain

Doctors at NYU Langone diagnose atypical facial pain based on the severity of your symptoms, focusing on the location of the pain as well as its frequency, intensity, and duration. A thorough review of your symptoms can help your doctor to determine the cause of the pain, which may be due to an underlying medical condition. If no underlying condition is determined to be the source, doctors refer to the pain as “atypical.”

Atypical facial pain is usually confined to one side of the face and often described as a burning or aching feeling. People who have had head trauma or numerous dental procedures have an increased chance of developing atypical facial pain. Psychological conditions, such as anxiety and depression, are also risk factors for atypical facial pain, with stressful life events sometimes preceding the onset of the pain.

Your doctor takes a thorough medical history and performs a physical exam to rule out other medical conditions that can cause facial pain, such as trigeminal neuralgia or migraines. Several diagnostic tools are used to pinpoint the cause of the pain.

Physical Examination

Doctors begin with a physical examination of the head, face, and neck to pinpoint the location of the pain and to determine if other medical factors, such as a compressed nerve or tumor, could be the source. Your doctor may also check for loss of feeling in the face or loss of sensation in the mouth to rule out damage to the trigeminal nerve, which controls sensation in the front of the face.

MRI Scan

MRI uses magnetic waves and computers to create two- or three-dimensional images. Your doctor may order an MRI scan to better view your head and neck and to rule out other conditions that can cause facial pain, such as trigeminal neuralgia, multiple sclerosis, or tumors.

MRA Scan

Magnetic resonance angiography is an imaging technique used to identify any abnormality of the blood vessels in the head and neck. The test involves injecting a dye into a blood vessel in the head or neck, allowing your doctor to view the blood flow in the arteries or veins in this area. The results can reveal if an abnormal blood vessel is pressing on a nerve and is the source of the facial pain.