Migraine presenting as isolated facial pain: A prospective clinical analysis of 58 cases

Abstract

Background: Sparse evidence has detailed the clinical phenotype of migraine presenting as isolated facial pain.Objective and methods: This was a prospective audit, part of our multidisciplinary facial pain service evaluation, aiming to phenotype patients with migraine presenting as isolated facial pain who attended our service between 2013 and 2018.

Results: Fifty-eight patients were diagnosed with migraine with isolated facial pain (F = 46, 79.3%; mean age: 49.0 years, ± 9.85). Sixty-six percent of patients met the criteria for episodic migraine. The pain was strictly unilateral in 79% and located over the maxillary region in 85% of patients. Associated cranial autonomic signs/symptoms were reported by 45% of our cohort. A percentage of 77% of patients was triptan responders.

Conclusions: Migraine presenting as isolated facial pain is a rare but treatable condition with some distinct demographic and clinical characteristics. It is a diagnosis of exclusion that should be evaluated in specialised multidisciplinary facial pain clinics.

Keywords: Migraine; atypical facial pain; facial pain; orofacial migraine.