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13. CRANIAL NEURALGIAS AND CENTRAL CAUSES OF FACIAL PAIN 13.1. Trigeminal neuralgia 13.2. Glossopharyngeal neuralgia 13.3. Nervus intermedius neuralgia [G51.80] 13.4. Superior laryngeal neuralgia [G52.20] 13.5. Nasociliary neuralgia [G52.80] 13.6. Supraorbital neuralgia [G52.80] 13.7. Other terminal branch neuralgias [G52.80] 13.8. Occipital neuralgia [G52.80] 13.9. Neck-tongue syndrome 13.10. External compression headache 13.11. Cold-stimulus headache 13.12. Constant pain caused by compression, irritation or distortion of cranial nerves or upper cervical roots by structural lesions [G53.8] + [code to specify aetiology] 13.13. Optic neuritis [H46]  13.14. Ocular diabetic neuropathy [E10-E14]  13.15. Head or facial pain attributed to herpes zoster 13.16. Tolosa-Hunt syndrome 13.17. Ophthalmoplegic “migraine” 13.18. Central causes of facial pain 13.18.1. Anaesthesia dolorosa [G52.800] + [code to specify aetiology] 13.18.2. Central post-stroke pain [G46.21] 13.18.3. Facial pain attributed to multiple sclerosis [G35] 13.18.4. Persistent idiopathic facial pain [G50.1] 13.18.5. Burning mouth syndrome [code to specify aetiology] 13.19. Other cranial neuralgia or other centrally-mediated facial pain [code to specify aetiology] Bibliography and reference14. OTHER HEADACHE, CRANIAL NEURALGIA, CENTRAL OR PRIMARY FACIAL PAIN 

IHS	Diagnosis	ICD-10
13.18.2	Central post-stroke pain [G46.21]	G44.810

Description:

Unilateral pain and dysaesthesia associated with impaired sensation involving part or the whole of the face, not explicable by a lesion of the trigeminal nerve. It is attributed to a lesion of the quintothalamic (trigeminothalamic) pathway, thalamus or thalamocortical projection. Symptoms may also involve the trunk and/or limbs of the affected or contralateral side.

Diagnostic criteria:

Pain and dysaesthesia in one half of the face, associated with loss of sensation to pin-prick, temperature and/or touch, fulfilling criteria C and D
One or both of the following:
1. history of sudden onset suggesting a vascular lesion (stroke)
2. demonstration by CT or MRI of a vascular lesion in an appropriate site
Pain and dysaesthesia develop within 6 months after stroke
Not explicable by a lesion of the trigeminal nerve

Comment:

Facial pain following a thalamic lesion is part of a hemisyndrome. With lateral medullary lesions hemifacial pain may occur in isolation, but it is more often accompanied by crossed hemidysaesthesia.

The pain and dysaesthesia are usually persistent.

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