PAIN MAPS FROM FACIAL-PAIN PATIENTS INDICATE A BROAD PAIN GEOGRAPHY

Two hundred consecutive female patients, who were referred to a univer sity-based facial pain clinic, were asked to mark all painful sites on sketches showing the contours of a human body in the frontal and rear views. The drawings were analyzed with transparent templates containi ng 1875 (frontal view) and 1929 (rear view) square cells of equal size . The average patient scored 71.8 cells in the frontal and 99.7 cells in the rear view (corresponding to 3.8% and 5.2% of the maximum possib le scores). In individual patient drawings, however, up to 42.7% and 4 4.9% of all cells were marked. Only 37 cases (18.5%) exhibited pain th at was limited to the trigeminal system. An analysis of the pain distr ibution according to the arrangements of dermatomes revealed three dis tinct clusters of patients: (1) pain restricted to the region innervat ed by the trigeminal nerves (n = 37); (2) pain in the trigeminal derma tomes and any combination involving the spinal dermatomes C2, C3, and C4, but no other dermatomes (n = 32); and (3) pain sites involving der matomes in addition to the ones Listed above (n = 131). Mean ages in t he three clusters were 38.7, 35.5, and 37.5 years, respectively (p = 0 .62, n.s.). Widespread pain existed for longer durations (median, 48 m onths) than conditions involving local and regional pain (median, 24 m onths) (p = 0.02, s.). Our findings showed that among a great percenta ge of persistent facial pain patients the pain distribution is more wi despread than commonly assumed, and that the persistence of pain in th e regional and widespread pain presentations is significantly greater than in cases with pain limited to the trigeminal system.