Atraumatic facial pain in adults - NICE guidance - suspected neurological conditions - recognition and referral

Facial pain, atraumatic

Summary points from NICE guidance relating to atraumatic facial pain are:

Facial pain with persistent facial numbness or abnormal neurological signs

Refer urgently adults with facial pain associated with persistent facial numbness or abnormal neurological signs for neuroimaging

Unilateral facial pain triggered by touching the face (trigeminal neuralgia)

Refer adults with unilateral facial pain that is triggered by touching the affected part of the face (trigeminal neuralgia) and is refractory to treatment

Scalp tenderness or jaw claudication suggestive of temporal arteritis

For adults with scalp tenderness or jaw claudication suggestive of temporal arteritis

• consider blood tests and follow local pathways for suspected giant cell (temporal) arteritis
• clinicians must be aware that a normal ESR (erythrocyte sedimentation rate) does not exclude a diagnosis of giant cell arteritis

Reference:

• NICE (May 2019). Suspected neurological conditions: recognition and referral