Classifying Your Pain

Dr. Kim Burchiel, the OHSU Brain Institute expert on facial pain and trigeminal neuralgia, has developed a system to classify facial pain. You may want to share this with your primary care doctor or other primary healthcare provider.

  • Trigeminal neuralgia, type 1, (TN1): facial pain of spontaneous onset (develops on its own, without an accident or injury) with greater than 50 percent limited to the duration of an episode of pain (temporary pain).
  • Trigeminal neuralgia, type 2, (TN2): facial pain of spontaneous onset with greater than 50 percent as a constant pain.
  • Trigeminal neuropathic pain, (TNP): facial pain resulting from unintentional injury to the trigeminal system from facial trauma, oral surgery, ear, nose and throat (ENT) surgery, root injury from posterior fossa or skull base surgery, stroke, etc.
  • Trigeminal deafferentation pain, (TDP): facial pain in a region of trigeminal numbness resulting from intentional injury to the trigeminal system from neurectomy, gangliolysis, rhizotomy, nucleotomy, tractotomy, or other denervating procedures (nerve surgeries).
  • Symptomatic trigeminal neuralgia, (STN): pain resulting from multiple sclerosis.
  • Postherpetic neuralgia, (PHN): pain resulting from trigeminal herpes zoster outbreak (infection with the virus that causes chicken pox and shingles).
  • Atypical facial pain, (AFP): pain predominantly having a psychological rather than a physiological origin (pain from a mental or emotional cause more than a physical cause).

In the OHSU Facial Pain Program, we have developed some questions to help you understand your facial pain. These are not a substitute for seeing your doctor if you have facial pain. The answers may help you decide to see your primary care doctor or a facial pain specialist.

Publications of Interest

A new classification for facial pain.
Burchiel KJ.
Neurosurgery. 2003 Nov;53(5):1164-6; discussion 1166-7.

Trigeminal neuralgia: definition and classification.
Eller JL, Raslan AM, Burchiel KJ.
Neurosurg Focus 2005 May 15;18(5):E3.

Design of an artificial neural network for diagnosis of facial pain syndromes.
Limonadi FM, McCartney S, Burchiel KJ.
Stereotact Funct Neurosurg. 2006;84(5-6):212-20. Epub 2006 Aug 18.