Orofacial Migraine-A Narrative Review

Area of Science:

• Neurology
• Headache Medicine

Background:

• The International Classification of Headache Disorders version 3 (ICHD-3) provides diagnostic criteria for migraine.
• ICHD-3 criteria do not specify the location of migraine pain.
• Increasing reports suggest migraine can manifest in the facial region, particularly the lower face.

Purpose of the Study:

• To review facial presentations of migraine.
• To discuss diagnostic challenges and potential pathophysiology of facial migraines.
• To differentiate facial migraine from similar conditions like neurovascular orofacial pain.

Main Methods:

• Literature review of studies on facial migraine and orofacial pain.
• Analysis of diagnostic criteria and clinical presentations.
• Discussion of proposed pathophysiological mechanisms.

Main Results:

• Facial migraines present in the lower face, mimicking sinusitis or dental issues.
• Diagnosis can be difficult due to non-specific location in ICHD-3 criteria.
• Neurovascular orofacial pain is a distinct but similar condition.

Conclusions:

• Facial migraine diagnosis requires careful consideration beyond standard criteria.
• Understanding the distinct symptomatology is crucial for accurate diagnosis and treatment.
• Further research into the pathophysiology of facial migraine is warranted.