Cheek Pain – New Zygomaticofacial Neuralgia

The  Zygomaticofacial Foramen  is 2 cm lateral and 2 cm inferior to the lateral canthus  (edge)  of the eye. A case of neuropathic pain from there that responded well to injection is documented.

Headache. 2018 Mar;58(3):455-457.
doi: 10.1111/head.13270.
Zygomaticofacial Neuralgia: A New Cause of Facial Pain.
Gómez-Mayordomo V, Gutiérrez-Viedma Á, Porta-Etessam J,  Rubio-Rodríguez, Cuadrado ML
http://onlinelibrary.wiley.com/doi/10.1111/head.13270/full
no abstract

  • 51 yr old lady – had prior radiotherapy for Graves disease thyroid
  •  pain and tenderness i on her right cheek with well-defined boundaries.
  • episodic  1-3 times/ day and lasted 2-24 hours.
  • Intensity =4 – 9/10
  • pain quality – pressing, sometimes throbbing
  • hyperalgesia in a 4 3 2cm area over the right zygomatic bone, the inferior region of the temple and the lateral aspect of the lower eyelid.
  • tenderness  restricted to Zygomaticofacial foramen
  • subcutaneous injection of 1 mL of bupivacaine 0.5% in the proximity of the zygomaticofacial foramen – 2 cm lateral and 2 cm inferior to the lateral canthus of the eye –with a 30-gauge needle – relief for 6 months

Comment  – you diagnose what you know and hopefully this makes something you will now know

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