About Headache & Facial Pain
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Headache and Facial Pain
A headache is a continuous pain in the head. Facial pain is pain felt in the facial area which includes the eyes and mouth.
What causes facial pain? - Sinus infections (sinusitis): This is an inflammation of the tissue lining the sinuses
- Deviated septum: This happens when the nasal septum (a thin structure separating the two sides of the nose) is not in the middle of the nose
- Temporomandibular Joint (TMJ) disorders: These are problems affecting the muscles and joints which connect the skull to the jaw on both sides of the head.
- Hypoparathyroidism: This is a rare condition which occurs when the parathyroid glands in the neck produce insufficient parathyroid hormone (PTH)
- Salivary gland infections (sialadenitis): These occur when a viral or bacterial infection affects the salivary gland or duct.
- Trigeminal neuralgia (TN): This is a condition which leads to intense pain in part or all of the face.
- Temporal arteritis: This occurs when the temporal arteries become damaged or inflamed.
- Mumps: This is a disease caused by a virus and is transmitted trough nasal secretions, saliva, and personal close contact. It is contagious.
- Glaucoma: This is an eye condition which damages the optic nerve.
- Acoustic neuroma: This is a benign tumor which grows on the nerve that connects your ear and your brain.
- Fibromyalgia: This is a chronic disorder which results in widespread unexplained pain in the tender points in joints and muscles.
- Multiple sclerosis (MS): This a chronic autoimmune disease which affects the central nervous system
- Polymyalgia rheumatic: This is an inflammatory disorder which causes muscle stiffness and pain.
Primary Headache Syndromes - Migraine: This is a throbbing, unilateral pain
- Cluster headache: This occurs as minutes to hours of severe unilateral temporal headache, which occurs in grouped attacks over several weeks to months.
- Tension headache: This causes mild to moderate pain. The pain is usually bilateral and nonpulsatile.
Secondary Facial Pain and Headache - Secondary facial pain and headache are usually attributed to the following causes.
- Vascular headache
- Head trauma and neck trauma
- Disorders of cranial and facial structures such as orbital pain, otalgia, cervical spine disorder
- Substance abuse or withdrawal such as caffeine withdrawal
- Oral cavity and craniomandibular pain
- Nonvascular intracranial disorders such as hydrocephalus, tumor
- Infection such as meningitis
- Homeostasis disorders such as hypoxia, hypertension
- Central and Idiopathic Facial Pain and Headache
- Two main idiopathic disorders that cause a headache and facial pains are midfacial segment pain (a tension-type headache of the midrace) and atypical facial pain (a constant deep unilateral pain)
Diagnosis - History: The doctor will ask you questions to try and diagnose the cause of a headache or facial pain. The doctor will ask about the onset, location, duration and relieving factors of the pain. They may also ask about you or your family¡¯s medical history with conditions such as sinusitis, rhinitis, and hyposmia. A full list of medications in use should be given to the doctor.
- Physical examination: The doctor will perform a comprehensive physical examination of the head and neck. This includes testing of trigger points, jaw clicks, palpation for points of tenderness and testing of the cranial nerves.
- Imaging tests
- Noncontrast CT of the sinuses
- MRA
- MRI
Treatment Treatment is usually determined by the possible causes of a headache or facial pain. In most cases, your doctor will consult with other specialists such as the otolaryngologist, neurologist, dentists and oral surgeons.
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