[Diagnosis of facial pain: a clinical experience]

A sample of 228 patients with facial pain is reported in the present paper. Among them, 112 cases are typical idiopathic trigeminal neuralgias, 111 are cases of secondary facial pain (including 7 cases symptomatic trigeminal neuralgias) and 5 patients were classified as vascular facial pain. Among the 119 cases of clinically diagnosed trigeminal neuralgias there were 112 (94, 11%) with no evidence of organic cause. Only 7 cases (5.89%) were identified as organic, including 3 cases of bulbar and pontic vascular lesions, 2 cases of iatrogenic injuries following neurosurgery, 1 case of meningioma of the ponto-cerebellar angle and 1 case of neurosyphillis. The most frequent conditions that produce secondary facial pain were: miofacial pain syndrome, sinusitis, cervical vertebral lesions, post herpetic neuralgias, malignant head and neck tumours and encephalic vascular lesions of the pain pathway.