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Facial Pain Radiating Upwards: Could the Pain of Epicrania Fugax Start in the Lower Face?
Author(s) -
Cuadrado MaríaLuz,
AledoSerrano Ángel,
JiménezAlmonacid Justino,
Lera Mercedes,
Guerrero Ángel L.
Publication year - 2015
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12492
Subject(s) - forehead , facial pain , medicine , scalp , chin , cheek , nose , anatomy , surgery
Background Epicrania fugax ( EF ) is characterized by painful paroxysms starting in a particular area of the head, and rapidly radiating forwards or backwards through the territories of different nerves. In former clinical descriptions, the pain moved between the posterior scalp ( C 2) and the frontal or periorbital area ( V 1), either in forward or backward direction. Methods We report 5 patients with a paroxysmal EF‐type pain starting in the lower face (V2 or V3) and radiating upwards. Results In each patient, the pain stemmed from the cheek (n = 1), the upper lip (n = 2) or the chin and mandibular area (n = 2), and then moved up to the forehead or the scalp with linear trajectory. Pain intensity was moderate (n = 1) or severe (n = 4), and pain quality was stabbing (n = 2) or electric (n = 3). The duration of attacks was very brief, lasting 1 to a few seconds. Three patients had ocular or nasal autonomic accompaniments, and 3 had triggers. Conclusions There seems to be a facial variant of EF . These observations could not only expand the clinical spectrum of EF but also enlarge the differential diagnosis of facial pain.