Facial Pain: Clinical and Anatomical Features of Damage to the Cranial Nerves and Temporomandibular Joint

Relevance. Facial pain (prosopalgia, orofacial pain) is one of the topical problems in clinical neurology. Complex anatomical, topographic and physiological characteristics of the facial area structure emphasize the need to understand their correlation when drawing up a clinical picture of individual nosological forms. In differential diagnostics and treatment of orofacial pain, the features of the pathogenetic mechanisms of pain are taken in to account. In addition to classical trigeminal neuralgia described in the first lecture, other variants of this pathology play an important role, as well as damage to other cranial nerves involved in the innervation of the facial area, such as the glossopharyngeal and vagus. Also in the international classification of orofacial pain (ICOP) a separate group is occupied by diseases associated with dysfunction of the temporomandibular joint, the causes of which can be arthralgia, myofascial pain in the face, reflected pain in case of damage to the cervical spine, neurostomatological syndromes, bruxism. The listed causes involve damage to various tissue structures: muscles, joints, ligaments, central and peripheral nervous system. Conclusion. Differential diagnostics of facial lesions should be carried out taking in to account knowledge of the anatomy, physiology, pathophysiology of the face. Correlation of clinical manifestations is based on interdisciplinary interaction of doctors of different specialties: neurologists, dentists, traumatologists. Only combined knowledge of the structural features, functions and pathology of the orofacial region will provide an up-to-date and differentiated approach to the treatment of facial pain.