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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