Can facial pain be a migraine?

My son has had chronic facial pain for three years.  He just turned 18 and I am at a loss after having had him treated by:  2 neurologists, dental surgeons, regular dentists, ENT specialists, facial surgeons and a pain management doctor.  I think they are all OFF THE MARK.  They BELIEVE that he has "facial migraines" and he's been jockeyed from one nasty drug to another.  I would like to know if there is conclusive evidence of such a disorder and if so, how is it diagnosed.  I believe that all of these doctors have been guessing and experiementing on my son.  I won't allow him to take any more drugs that dibilitate him. 

THANK FOR ANY HELP YOU MAY LEND US.

Your son's case sounds exactly like what I went through. Even the amount of doctors were the same. I don't know where you are from, but after a 2 years of pain, I searched the computer and came up with the Jefferson Headache Center in Philadelphia, Pa. There is a pain management doctor there and and headache clinic, that they only have 4 of in the country. They are very thorough and are tops in their field. If you need anymore information, I would be very happy to help you....Franny

Thank you, Franny for you kind response.  Can you tell me who the doctor is that treated you as my son is seeing a pain management doctor at Jefferson now.  I guess I'm looking for a solution that has been a long time coming and unfortunately, from everything that I've read, it may take years.  He's too young to have to put his life on hold at times and we never know when the pain will be at its worse, therefore impossible to plan an event.

Anyway, I'm trying not to complain but rather find a solution.

Thank you very much for taking the time to answer me.

Loretta

Loretta,

If you son is seeing a pain management doctor at the Jefferson, I recommend getting him an appointment at their Headache Center. Pain management doctors are generally not Migraine specialists, but the doctors at the Jefferson Headache Center are. Especially if he's still been given only the diagnosis of "facial Migraines," he needs to be seen by a doctor who knows Migraine disease and how to treat it. There are several different forms of Migraine, but "facial Migraine" is NOT one of them.

Teri

Loretta, I highly, highly, recommend Dr. Alan Stiles. Maxillofacial Surgery Dept. of Jefferson. I just went through a tough time for 4 years and never thought I'd see the light at the end of the tunnel. But, thanks to Dr. Stiles I have. 

Dr. Stiles is wonderful! I've talked with him when I was at the Jefferson.

Here's the thing though. You and I can't tell why Loretta's son has facial pain with his Migraines. Seeing Dr. Stiles may or may not be the answer for him. Thus my suggestion that he be seen at the Jefferson Headache Center. The doctor he would see at the Headache Center would get him in to see Dr. Stiles if the reason for his facial pain falls into Dr. Siles's are of expertise, and the appointment would probably be much sooner.

I often have a great deal of facial pain with my Migraine, but there's nothing Dr. Stiles can do for me. Really, that ends up being a good thing. The facial pain I have is from inflammation of the trigeminal nerve, which I explained in my answer to the original question here. That means the the best thing I can do for the facial pain is take medications to prevent as many Migraines as possible, and when I get a Migraine, take medications to abort it as quickly as possible.

Teri

Franny,

I don't want to belabor the point, but types of Migraine and correct diagnoses are extremely important. Most doctors, including those at the Jefferson Headache Center, follow the gold standard for diagnosis and classification of Migraine and other headache disorders -- the International Headache Society's International Classification of Headache Disorders, 2nd Edition. Under this system, there exist the following Migraine diagnoses:

1.1 Migraine without aura
1.2 Migraine with aura
      1.2.1 Typical aura with migraine headache
      1.2.2 Typical aura with non-migraine headache
      1.2.3 Typical aura without headache
      1.2.4 Familial hemiplegic migraine (FHM)
      1.2.5 Sporadic hemiplegic migraine
      1.2.6 Basilar-type migraine
1.3 Childhood periodic syndromes that are commonly precursors of migraine
      1.3.1 Cyclical vomiting
      1.3.2 Abdominal migraine
      1.3.3 Benign paroxysmal vertigo of childhood
1.4 Retinal migraine
1.5 Complications of migraine
      1.5.1 Chronic migraine
      1.5.2 Status migrainosus
      1.5.3 Persistent aura without infarction
      1.5.4 Migrainous infarction
      1.5.5 Migraine-triggered seizures
1.6 Probable migraine
      1.6.1 Probable migraine without aura
      1.6.2 Probable migraine with aura
      1.6.5 Probable chronic migraine

The phrase "facial Migraines" may be used as a description, but it's not a diagnosis.

Teri

Thank you for your response.  Max is already going to Dr. Stiles.  What's happening now is that he is on high doses of drugs that have horrible side effects.  We've been down the road with Neurologists who had him on Tegratol that sent him to the hospital; then, Lyrica, Neurotin, Neurtryptolin and now Topamax.  None have been effective against the pain without opiods that are very distressing.  I guess we'll have to stick to the program but I would like to investigate further.  Is Doctor Stiles also a part of the Jefferson Headache group?

Thanks again for your kind help.

Loretta

Hi Loretta, I answered this before but didn't see the post, so I'm answering again. Dr. Stiles is, in my opinion, an expert on migranes. He works with the headache center, which is across the street from his office. When none of the drugs helped me, he sent me across to the headache center. I was there all day, tested for 6 hrs. The final result was botox shots for my headaches. Now, I am back over Dr. Stile's office and he administers them to me about every 3 to 4 months. I have been about 80% better with them and the pills I am on.

Thank you again for your kind response.  I guess we'll endure a while longer and it's nice to know that Dr. Stiles is a good doctor.  My son likes him a lot and trusts him so that's half the battle.  Unfortunately, I'm on the receiving end of his pain and would like it to go away NOW. 

Did you also have to go through the series of meds before going to the botox injections?