There are numerous variants of facial pain syndromes that do not manifest with classic symptoms of trigeminal neuralgia. These syndromes can be grouped as atypical facial pain.
These conditions can present with bilateral facial pain (pain on both sides of the face), neuropathic pain (burning, continuous pain) and pain that is not discordant (out of proportion to stimulus – like light touch or chewing).
Atypical facial pain is generally NOT caused by a blood vessel contacting the trigeminal nerve and, hence, microvascular decompression surgery is not typically helpful. However, numerous treatment options exist ranging from medications to ablative procedures such as radiofrequency ablation and balloon compression of the trigeminal nerve. More advanced treatments such as cortical stimulation and deep brain stimulation are available for refractory patients.
