Incidence of facial pain in the general population

Koopman, Joseph S.H.A.; Dieleman, Jeanne P.; Huygen, Frank J.; de Mos, Marissa; Martin, Carola G.M.; Sturkenboom, Miriam C.J.M.

doi:10.1016/j.pain.2009.08.023

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Volume 147, Issue 1 , Pages 122-127, 15 December 2009

Incidence of facial pain in the general population

Joseph S.H.A. Koopman
- Dept. of Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
- Corresponding author. Address: Dept. of Medical Informatics, Room 21.55, Dr. Molewaterplein 50, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Tel.: +31 10 7044133; fax: +31 10 7044722.
Jeanne P. Dieleman
- Dept. of Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
Frank J. Huygen
- Dept. of Pain Treatment, Erasmus MC, Rotterdam, The Netherlands
Marissa de Mos
- Dept. of Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
Carola G.M. Martin
- Dept. of Pain Treatment, Erasmus MC, Rotterdam, The Netherlands
Miriam C.J.M. Sturkenboom
- Dept. of Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
- Dept. of Epidemiology, Erasmus MC, Rotterdam, The Netherlands

Received 4 November 2008; received in revised form 17 August 2009; accepted 25 August 2009. published online 28 September 2009.

Abstract

Facial pain has a considerable impact on quality of life. Accurate incidence estimates in the general population are scant. The aim was therefore to estimate the incidence rate (IR) of trigeminal neuralgia (TGN), postherpetic neuralgia (PHN), cluster headache (CH), occipital neuralgia (ON), local neuralgia (LoN), atypical facial pain (AFP), glossopharyngeal neuralgia (GPN) and paroxysmal hemicrania (PH) in the Netherlands. In the population-based Integrated Primary Care Information (IPCI) medical record database potential facial pain cases were identified from codes and narratives. Two medical doctors reviewed medical records, questionnaires from general practitioners and specialist letters using criteria of the International Association for the Study of Pain. A pain specialist arbitrated if necessary and a random sample of all cases was evaluated by a neurologist. The date of onset was defined as date of first specific symptoms. The IR was calculated per 100,000PY. Three hundred and sixty-two incident cases were ascertained. The overall IR [95% confidence interval] was 38.7 [34.9–42.9]. It was more common among women compared to men. Trigeminal neuralgia and cluster headache were the most common forms among the studied diseases. Paroxysmal hemicrania and glossopharyngeal neuralgia were among the rarer syndromes. The IR increased with age for all diseases except CH and ON, peaking in the 4th and 7th decade, respectively. Postherpetic neuralgia, CH and LoN were more common in men than women. From this we can conclude that facial pain is relatively rare, although more common than estimated previously based on hospital data.