{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T15:21:49Z","timestamp":1771687309081,"version":"3.50.1"},"reference-count":18,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Orofacial pain syndromes (OFPs) are a heterogeneous group of syndromes mainly characterized by painful attacks localized in facial and oral structures. According to the International Classification of Orofacial Pain (ICOP), the last three groups (non-dental facial pain, NDFP) are cranial neuralgias, facial pain syndromes resembling primary headache syndromes, and idiopathic orofacial pain. These are often clinical challenges because the symptoms may be similar or common among different disorders. The diagnostic efforts often induce a complex diagnostic algorithm and lead to several imaging studies or specialized tests, which are not always necessary. The aim of this study was to describe the encountered difficulties by these patients during the diagnostic\u2013therapeutic course. Methods: This study was based on the responses to a survey questionnaire, administered to an Italian Facebook Orofacial Patient Group, searching for pain characteristics and diagnostic\u2013therapeutic care courses. The questionnaire was filled out by patients affected by orofacial pain, who were 18 years and older, using a free online tool available on tablets, smartphones, and computers. Results: The sample was composed of 320 subjects (244F\/76M), subdivided by age range (18\u201335 ys: 17.2%; 36\u201355 ys: 55.0%; &gt;55 ys 27.8%). Most of the patients were affected by OFP for more than 3 years The sample presented one OFP diagnosis in 60% of cases, more than one in 36.2% of cases, and 3.8% not classified. Trigeminal neuralgia is more represented, followed by cluster headaches and migraines. About 70% had no pain remission, showing persisting background pain (VAS median = 7); autonomic cranial signs during a pain attack ranged between 45 and 65%. About 70% of the subjects consulted at least two different specialists. Almost all received drug treatment, about 25% received four to nine drug treatments, 40% remained unsatisfied, and almost 50% received no pharmacological treatment, together with drug therapy. Conclusion: To the authors\u2019 knowledge, this is the first study on an OFP population not selected by a third-level specialized center. The authors believe this represents a realistic perspective of what orofacial pain subjects suffer during their diagnostic\u2013therapeutic course and the medical approach often results in unsatisfactory outcomes.<\/jats:p>","DOI":"10.3390\/ijerph20206946","type":"journal-article","created":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T07:25:22Z","timestamp":1697786722000},"page":"6946","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Orofacial Migraine and Other Idiopathic Non-Dental Facial Pain Syndromes: A Clinical Survey of a Social Orofacial Patient Group"],"prefix":"10.3390","volume":"20","author":[{"given":"Federica","family":"Reina","sequence":"first","affiliation":[{"name":"Child Neuropsychiatry Unit Department, Pro.M.I.S.E. \u201cG D\u2019Alessandro\u201d, University of Palermo, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3756-4323","authenticated-orcid":false,"given":"Giuseppe","family":"Salemi","sequence":"additional","affiliation":[{"name":"Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariarita","family":"Capizzi","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit Department, Pro.M.I.S.E. \u201cG D\u2019Alessandro\u201d, University of Palermo, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Lo Cascio","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit Department, Pro.M.I.S.E. \u201cG D\u2019Alessandro\u201d, University of Palermo, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Marino","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit Department, Pro.M.I.S.E. \u201cG D\u2019Alessandro\u201d, University of Palermo, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Santangelo","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Department, ISMEP\u2014ARNAS Civico Palermo, via dei Benedettini 1, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2668-6373","authenticated-orcid":false,"given":"Andrea","family":"Santangelo","sequence":"additional","affiliation":[{"name":"Pediatric Neurology, Pediatric Department, AOUP Santa Chiara Hospital, 56121 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Mineri","sequence":"additional","affiliation":[{"name":"Pain Management Department, Humanitas, 95045 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5875-3126","authenticated-orcid":false,"given":"Filippo","family":"Brighina","sequence":"additional","affiliation":[{"name":"Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6149-0881","authenticated-orcid":false,"given":"Vincenzo","family":"Raieli","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Department, ISMEP\u2014ARNAS Civico Palermo, via dei Benedettini 1, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmelo Attilio","family":"Costa","sequence":"additional","affiliation":[{"name":"Pain Management Department, Humanitas, 95045 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"The Orofacial Pain Classification Committee (2020). International Classification of Orofacial Pain, 1st Edition (ICOP). Cephalalgia, 40, 129\u2013221.","DOI":"10.1177\/0333102419893823"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1177\/0333102420928080","article-title":"The ICHD Definition of \u201cfacial Pain\u201d Should Be Revised","volume":"40","author":"Ziegeler","year":"2020","journal-title":"Cephalalgia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1093\/bja\/aet125","article-title":"Differential Diagnosis of Facial Pain and Guidelines for Management","volume":"111","author":"Zakrzewska","year":"2013","journal-title":"Br. J. Anaesth."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"E1138","DOI":"10.1212\/WNL.0000000000008124","article-title":"Facial Presentations of Migraine, TACs, and Other Paroxysmal Facial Pain Syndromes","volume":"93","author":"Ziegeler","year":"2019","journal-title":"Neurology"},{"key":"ref_5","first-page":"81","article-title":"Idiopathic Facial Pain Syndromes\u2014An Overview and Clinical Implications","volume":"118","author":"Ziegeler","year":"2021","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1097\/WCO.0000000000000927","article-title":"Facial Pain beyond Trigeminal Neuralgia","volume":"34","author":"May","year":"2021","journal-title":"Curr. Opin. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S1474-4422(06)70375-1","article-title":"Facial Pain: Clinical Differential Diagnosis","volume":"5","author":"Siccoli","year":"2006","journal-title":"Lancet Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.2147\/JPR.S294404","article-title":"A Review of Current Perspectives on Facial Presentations of Primary Headaches","volume":"15","author":"Peng","year":"2022","journal-title":"J. Pain. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd Edition","volume":"38","author":"Olesen","year":"2018","journal-title":"Cephalalgia"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1111\/j.1468-2982.2004.00936.x","article-title":"Facial Pain in a Neurological Tertiary Care Centre--Evaluation of the International Classification of Headache Disorders","volume":"25","author":"Zebenholzer","year":"2005","journal-title":"Cephalalgia"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1111\/head.14212","article-title":"Characteristics and Natural Disease History of Persistent Idiopathic Facial Pain, Trigeminal Neuralgia, and Neuropathic Facial Pain","volume":"61","author":"Ziegeler","year":"2021","journal-title":"Headache"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/j.1468-2982.2009.01899.x","article-title":"Prevalence of Facial Pain in Migraine: A Population-Based Study","volume":"30","author":"Yoon","year":"2010","journal-title":"Cephalalgia"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Correnti, E., Lo Cascio, S., Cernigliaro, F., Rossi, R., D\u2019Agnano, D., Grasso, G., Pellegrino, A., Lauria, B., Santangelo, A., and Santangelo, G. (2023). Idiopathic Non-Dental Facial Pain Syndromes in Italian Children: A Clinical Case Series. Life, 13.","DOI":"10.3390\/life13040861"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Raieli, V., Reina, F., D\u2019agnano, D., Nocera, G.M., Capizzi, M., Marchese, F., and Sciruicchio, V. (2022). The Pediatric Trochlear Migraine: Diagnostic and Therapeutic Implications. J. Clin. Med., 11.","DOI":"10.3390\/jcm11102826"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.cden.2018.05.001","article-title":"An Introduction to Orofacial Pain","volume":"62","author":"Crandall","year":"2018","journal-title":"Dent. Clin. N. Am."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Sharav, Y., Haviv, Y., and Benoliel, R. (2023). Orofacial Migraine or Neurovascular Orofacial Pain from Pathogenesis to Treatment. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24032456"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Clark, G.T., and Dionne, R.A. (2012). Orofacial Pain: A Guide to Medications and Management, Wiley.","DOI":"10.1002\/9781118704851"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Manzo, M.L., Reina, F., Correnti, E., D\u2019Aiuto, F., D\u2019Agnano, D., Santangelo, A., Vetri, L., Santangelo, G., Maniscalco, L., and Tripi, G. (2023). Evolution of Pediatric Migraine Patients Admitted at an Emergency Department after a 10-Year Follow-Up. J. Clin. Med., 12.","DOI":"10.3390\/jcm12072475"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/20\/6946\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:10:10Z","timestamp":1760130610000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/20\/6946"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,20]]},"references-count":18,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["ijerph20206946"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20206946","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,20]]}}}