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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
13.18.3	Facial pain attributed to multiple sclerosis [G35]	G44.847
Coded elsewhere	Pain attributed to optic neuritis occurring as a manifestation of multiple sclerosis is coded as 13.13 Optic neuritis .

Description:

Unilateral or bilateral facial pain, with or without dysaesthesia, attributed to a demyelinating lesion of the central connections of the trigeminal nerve, which commonly remits and relapses.

Diagnostic criteria:

Pain, with or without dysaesthesia, in one or both sides of the face
Evidence that the patient has multiple sclerosis
Pain and dysaesthesia develop in close temporal relation to, and with MRI demonstration of, a demyelinating lesion in the pons or quintothalamic (trigeminothalamic) pathway
Other causes have been ruled out

Comment:

Pain may be tic-like, as in 13.1 Trigeminal neuralgia, or continuous. Trigeminal neuralgia occurring in young people or affecting one and then the other side should arouse the suspicion of multiple sclerosis.

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IHS vs. ICD-10

To facilitate headache diagnosis in daily practice, the classification provides the corresponding WHO ICD-10NA codes for each IHS code.

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