Diferential diagnosis in atypical facial pain: a clinical study

objetive: to evaluate a sample of patients with atypical facial pain (afp) in comparison to patients with symptomatic facial pain (sfp). method: 41 patients with previous diagnostic of afp were submitted to a standardized evaluation protocol, by a multidisciplinary pain team. results: 21 (51.2%) were considered afp and 20 (48.8%) (sfp) received the following diagnosis: 8 (40.0%) had temporomandibular disorders (tmd); 3 (15.0%) had tmd associated to systemic disease (fibromyalgia, systemic erythematosus lupus); 4 (20.0%) had neuropathy after ear, nose and throat (ent) surgery for petroclival tumor; 2 (10.0%) had wallenberg syndrome; 1 (5.0%) had intracranial tumor; 1 (5.0%) had oral cancer (epidermoid carcinoma), and 1 (5.0%) had burning mouth syndrome (bms) associated to fibromyalgia. spontaneous descriptors of pain were not different between afp and sfp groups (p=0.82). allodynia was frequent in sfp (p=0.05) and emotion was the triggering factor most prevalent in afp (p=0.06). afp patients had more traumatic events previously to pain (p=0.001). conclusion: afp patients had more: a) traumatic events previously to pain onset, and b) emotions as a triggering factor for pain. these data support the need of trained health professionals in multidisciplinary groups for the accurate diagnosis and treatment of these patients.