Abstract text (incl. figure legends and references)

The sites of the migraine headache are predominantly temporal, supraorbital, frontal, parietal, and occipital. However, they may occur in the orofacial region also. Referral of pain to maxillary teeth is not uncommon. In view of the uncommon pain location, a high number of these patients are misdiagnosed with dental or sinus-related conditions, frequently resulting in inappropriate surgical and medical treatments. If the oro-facial area is the focus of the pain, the newly developed International Classification of orofacial pain refers to "Orofacial Migraine" and "Trigeminal autonomic orofacial pain". Benoliel et al introduced the term Neurovascular oro-facial pain (NVOP), previously also described as lower facial migraine.

Migraine can be localized in the face resembling facial or dental pain, indicating the influence of the trigeminovascular system in the structures innervated by the maxillary and mandibular branches of the trigeminal nerve. The clinical features of NVOP contains a distinctive combination of signs and symptoms common to both migraine and trigeminal autonomic cephalalgias. In contrast to migraine, patients are older at the time of onset and even more predominantly female. Frequently, there is cold allodynia of several teeth. This finding needs to be investigated properly, since it would be an important test and might link this entity to migraine, in which mechanical allodynia is seen during attacks.

NVOP is becoming increasingly recognized in medical and dental clinics. It is important for clinicians evaluating patients with facial pain to show their diligence and identify the associated symptoms of migraine, so as to avoid unnecessary treatments and surgical procedures and deliver appropriate medical therapy. The collaboration between neurologists and facial pain specialists is key to increasing awareness and education on this rare but treatable manifestation of an otherwise very frequent headache disorder.

References

Interplay of Oral, Mandibular, and Facial Disorders and Migraine Curr Pain Headache Rep 2022 May Migraine presenting as isolated facial pain:Cephlalgia 2020 International Classification of Orofacial Pain. Cephalalgia 2020