Atypical facial pain

Atypical facial pain
Synonyms	atypical facial neuralgia, chronic idiopathic facial pain, psychogenic facial pain phantom tooth pain, psychogenic toothache, persistent dentoalveolar pain disorder ICD10 = G50.1 (Atypical facial pain), K08.8 ("Toothache not otherwise specified")
Classification and external resources
Specialty	gastroenterology
ICD-9-CM	350.2
DiseasesDB	1129
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atypical facial neuralgia, chronic idiopathic facial pain, psychogenic facial pain phantom tooth pain, psychogenic toothache, persistent dentoalveolar pain disorder

Atypical facial pain (AFP) is a type of chronic facial pain which does not fulfill any other diagnosis. There is no consensus as to a globally accepted definition, and there is even controversy as to whether the term should be continued to be used. Both the International Headache Society (IHS) and the International Association for the Study of Pain (IASP) have adopted the term persistent idiopathic facial pain (PIFP) to replace AFP. In the 2nd Edition of the International Classification of Headache Disorders (ICHD-2), PIFP is defined as "persistent facial pain that does not have the characteristics of the cranial neuralgias [...] and is not attributed to another disorder." However, the term AFP continues to be used by the World Health Organization's 10th revision of the International Statistical Classification of Diseases and Related Health Problems and remains in general use by clinicians to refer to chronic facial pain that does not meet any diagnostic criteria and does not respond to most treatments.

The main features of AFP are: no objective signs, negative results with all investigations/ tests, no obvious explanation for the cause of the pain, and a poor response to attempted treatments. AFP has been described variably as a medically unexplained symptom, a diagnosis of exclusion, a psychogenic cause of pain (e.g. a manifestation of somatoform disorder), and as a neuropathy. AFP is usually burning and continuous in nature, and may last for many years. Depression and anxiety are often associated with AFP, which are either described as a contributing cause of the pain, or the emotional consequences of suffering with unrelieved, chronic pain. For unknown reasons, AFP is significantly more common in middle aged or elderly people, and in females.

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