27 September 2019

You probably didn't know about this type of migraine - and it strikes with more than just a headache

It's bad enough having an aching head, but this type lesser known type of migraine packs an additional punch.

It's bad enough to have an aching head, but about one in 10 people who suffer from headaches also experience facial pain, researchers have found.

The study included more than 2 900 people with primary headaches. These are ones not caused by another condition and they include migraine and cluster headaches. Participants completed questionnaires about their headaches and any facial pain.

Highest rate of facial pain

People with dental problems that could explain facial pain were not included in the study.

Ten percent of patients reported having facial pain. Those with paroxysmal hemicrania – a type of headache with severe, often short attacks on one side of the head – had the highest rate of facial pain (45%).

Facial pain also affected 21% of patients with hemicrania continua, a headache with continuous pain that varies in severity; 20% of those with short-lasting unilateral neuralgiform, a headache characterised by frequent attacks on one side of the head; 15% of those with cluster headache; and 2% of migraine sufferers, the investigators found.

Among those with migraine who did experience facial pain, 41% experienced pain mostly in the face. And among cluster headache patients who experienced facial pain, 31% felt the pain mostly in their face, according to the study.

Six patients in the study had constant facial pain on one side of the head only, in addition to facial pain attacks lasting 10 to 30 minutes several times a day. This type of pain syndrome has not been described before, and researchers suggested calling it "constant unilateral facial pain with added attacks," the study authors said in a news release from the American Academy of Neurology.

Proper diagnosis and treatment

"Facial pain has not been well recognised as a symptom of headache, and some people end up waiting a long time for a proper diagnosis and treatment," study author Dr Arne May said in the news release. "This study shows that facial pain is not uncommon, and for many people their pain occurs mainly in the face, not the head."

May is a professor of neurology at the University of Hamburg, in Germany.

"For a better understanding of these types of facial pain and ultimately for the development of treatments, it's crucial that we understand more about facial pain and whether it is the same disease as the headache, but showing up in a different place, or whether they are two different syndromes," he concluded.

The report was published in the online issue of the journal Neurology.

Image credit: iStock


Ask the Expert

Headache expert

Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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