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Interventions for Atypical Facial Pain: A Review of Clinical Effectiveness and Guidelines

Published on: April 1, 2016
Project Number: RC0763-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of pharmacological and non-pharmacological interventions for patients with atypical facial pain?
  2. What are the evidence-based guidelines regarding interventions for patients with atypical facial pain?

Key Message

A number of therapeutic options are available for managing atypical facial pain, including surgical interventions, non-surgical non-drug interventions, and drug treatments. Seven non-randomized studies on surgical procedures for atypical facial pain were identified that reported generally poor outcomes related to pain relief and complications or adverse events among this patient population. Likewise, limited evidence of the clinical effectiveness of non-surgical interventions (drug and non-drug) was reported by five non-randomized studies and two randomized controlled trials; non-surgical approaches were found to attenuate pain symptoms in some patients, but not all patients responded well to these treatment modalities. These findings warrant careful interpretation in light of several limitations, including small sample sizes, the retrospective nature of included studies, and the fact that many studies had no control group. The applicability of the identified published literature is also limited for the Canadian context given the lack of studies conducted in this setting. One evidence-based guideline was identified that recommends first-line treatment with pharmacologic agents for the management of atypical facial pain, followed by minimally-invasive surgical intervention for patients who are uncontrolled on drug therapy.

Tags

anesthesia, facial neuralgia, facial pain, nervous system, idiopathic facial pain