Thursday, October 23, 2014
Tuesday, August 25, 2009 springtimemum, Community Member, asks

Q: Can facial pain be a migraine?



I have pain that is severe, fairly constant and pressure like that is all one side of my head - from the side of my nose, under my eye, up to my temple (most intense) and round to my ear. It has increased in duration, frequency and intensity over past year and the longest period it has lasted for is 12 days. In the past I have used ibruprofen and paracetomol in high dosages to bring the pain into tolerance level but recently I experienced two days of this pain without it responding to medication (I was going nuts!).


The pain is not at all like a headache, it sometimes feels like it radiates down to my jaw or up into my head, but usually doesn't. It is mostly on my face.


I have no aura or visual disturbances, no vomitting or nausea. Have had my eyes checked - I do not need glasses and my eyes are healthy.


My doctor has suggested it could be a migraine and has suggested I try beta-blockers but I have been unable to find reference to migraine's on the face that fit even close to my description... can anyone shed some light please or point me in the direction of finding more information? Thanks in advance.


P.S. I never previously had any history of migraines or headaches - this pain started approx 4 weeks after I had a whip lash injury to my neck.


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Answers (3)
Teri Robert, Health Guide
9/ 1/09 4:26pm

During a Migraine, the trigeminal nerve becomes inflamed. When you see the position of that nerve, you can see why a Migraine can make your face hurt. You can see the location of the trigeminal nerve in this illustration - Pathways of Migraine.


That said, a diagnosis of Migraine requires symptoms other than headache -- nausea, vomiting, sensitivity to light or sound. You can read more about the phases of a Migraine attack and their symptoms in Anatomy of a Migraine.


Is there any history of Migraine, "sick headaches," or sinus headaches in your family? Most of what people think are sinus headaches are actually Migraines.


Another possibility is that this is post-traumatic pain. It can often act a lot like Migraine.


If your doctor isn't able to help you, it may well be time to consult a Migraine and headache specialist. It's important to note that neurologists aren't necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.


hope this helps,


frannytal, Community Member
8/27/09 4:44pm

Yes. There is such a thing as facial migranes. After a car accident, and a year of suffering, I was diagnosed at the Jefferson University Hospital. It's been 4 long years, but the treatment has been finally working.  I would be happy to help you.

Loretta Stevens, Community Member
10/ 7/09 10:25am

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. 



frannytal, Community Member
10/ 7/09 5:31pm

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

Loretta Stevens, Community Member
10/ 9/09 9:51am

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.



Teri Robert, Health Guide
10/ 9/09 12:14pm



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.



frannytal, Community Member
10/ 9/09 1:32pm

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. 

Teri Robert, Health Guide
10/ 9/09 1:46pm

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 Robert, Health Guide
10/ 9/09 1:51pm



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.



Loretta Stevens, Community Member
10/ 9/09 3:34pm

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.



frannytal, Community Member
10/10/09 7:51pm

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.

Loretta Stevens, Community Member
10/11/09 11:22am

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? 

Terrt, Community Member
9/14/12 10:37pm

I want to continue with the post on the Philadelphia Jefferson Headache Clinic. I also appreciate the diagnostic skills of Dr. Stiles. For years I suffered a terrible aching pain on the left side of my face that seemed to be related sometimes to the weather & sometimes it just seemed random. After having gone  through a root canal and sinus surgery and being examined for neurosurgeon, I was referred to Dr. Stiles at Jefferson Hospital. He was the first one to diagnose me with migraines with atypical face pain. When I didn't  respond to several different treatments he was able to obtain a referral to the Jefferson Head Clinic. After a thorought work up including a psychological and physical exam we were able to find a treatment that controlled my face pain and headaches. I never would have made the connection between the face pain and migraine without Dr. Stiles.

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By springtimemum, Community Member— Last Modified: 09/14/12, First Published: 08/25/09