Diagnosis
The typical course and spread of pain are extremely characteristic, so that even the description of the pain attacks can provide an important indication of the presence of neuralgia. The diagnosis should be confirmed by a neurologist who, with the help of imaging techniques and the examination of blood and cerebrospinal fluid samples, can rule out other causes and make the exact diagnosis. If a clearly identifiable cause can be found, it should be treated. However, if there is no obvious underlying disease, medication and possibly even surgery is often advised.
Unilateral facial pain
The information whether the facial pain is only present on one side or affects the entire face is very important, as it is a guiding indication in the diagnostic process. For example, certain diseases that lead to nerve pain classically occur on one side only. These clinical pictures include neuralgia, for example of the nervus glossopharyngeus.
Here, similar to trigeminal neuralgia, the nerve of the same name is highly irritated and leads to correspondingly severe pain in its area of supply. The tongue, pharynx and parotid gland on one half of the face are affected. A difference in frequency between the two halves of the face could not be proven.
Another disease whose classic feature is unilateral facial pain is shingles on the face. It can affect various nerves in the face, but the typical nerve pain and skin changes, such as redness and blistering, are usually always present. However, a quick therapy should be aimed at, otherwise in severe cases, the nerves may lose their function. A locally very limited pain on the left side of the lower jaw can indicate an acute heart problem, such as a heart attack.However, these are usually accompanied by other symptoms such as a feeling of tightness, pain in the upper abdomen or left arm and feelings of anxiety.
Bilateral facial pain
Bilateral facial pain can be caused by variable diseases, so it is advisable to consult a physician in the presence of bilateral pain that lasts longer in order to exclude possible serious causes. The most common cause is probably an inflammation of the paranasal sinuses, which usually subsides on its own. However, a facial pain that occurs on both sides can also be an indication of a systemic underlying disease.
For example, patients with multiple sclerosis (MS) are often reported to suffer from bilateral nerve pain in the facial region. As the disease progresses, an increasing loss of nerve function is also possible. Furthermore, facial pain occurring on both sides can also be caused by polyneuropathy. The causes of a polyneuropathy can be very diverse and range from alcoholism, diabetes to treatment with certain chemotherapeutic agents. Neuropathy differs from neuralgia in that it is usually accompanied by sensory disturbances such as tingling, rather than pain.
