Foreword for: Trigeminal neuralgia and persistent idiopathic facial pain (Atypical facial pain)

The patient presentation to their primary care clinician for Trigeminal Neuralgia or persistent idiopathic facial pain (Atypical facial pain) often reflects a sojourn of less than adequate attempts directed at treatment for pain relief. Identification and diagnosis of these syndromes is often preceded by self-initiated modalities that may include over-the-counter medications, phytopharmaceuticals, substances of abuse, alcohol, and use of controlled substances. This is further complicated by interventions involving acupuncture, dental, chiropractic, and complementary techniques. Upon initial presentation to the primary care clinician, the patient often expresses and social discord. To address this dilemma, this article will examine the etiology, diagnosis, evaluation, presentation, the variety of treatments and available pharmacotherapies for Trigeminal Neuralgia or persistent idiopathic facial pain (Atypical facial pain). Each pharmacotherapy is to be initiated in a patient-specific, patient-focused and patient- centered personalized care plan by "going low and slow" with each opportunity to decrease both the discomfort and adverse events. The patient expectations of each intervention should be discussed thoroughly.