By Edmund Messina, MD, Medical Director of the Michigan Headache Clinic in East Lansing, Michigan While headaches are typically thought to be located around the forehead or back of the head, there are types of headache that strike the face itself. Trigeminal neuralgia is a form of severe facial pain in which patients experience brief volleys of very painful electric shock sensations triggered by mild touch to the face or mouth. This touch can be from washing, shaving, eating, brushing the teeth or even talking. The trigger zones are particularly sensitive in the area between the nose and mouth or on the chin.

Q. I have been suffering from numbness of the scalp, forehead and around my eye and nose. The numbness is predominantly right-sided and more pronounced when I wear my glasses and wipe my head with a towel. These symptoms have been intermittent for years. They last for weeks and can go into remission for weeks at a time. I have been diagnosed with migraine, trigeminal neuralgia, cranial syndrome, cervicalgia and occipital neuralgia. The symptoms still persist despite trials of a number of medications.

Q. For the past two weeks I have been getting a weird symptom and I can’t seem to find out what it is. Every time I gently touch or brush a certain part of my hair along my head, I get a slightly painful feeling of pressure around the area. The weird thing is, if I touch the area with mild force, it doesn’t hurt at all. Any idea what this might be?

Chronic facial pain can be very confusing both to the patient and healthcare provider. This can be direct pain - involving nerves that supply the face or indirect (referred) pain from other structures in the head such as blood vessels. The pain may be related...