Psychosomatic Medicine 13:375-396 (1951)
© 1951 American Psychosomatic Society

Primary Atypical Facial Neuralgia

An Hysterical Conversion Symptom

¹ Departments of Psychiatry and Medicine, University of Rochester School of Medicine and Dentistry Rochester, New York

Twenty patients, 19 women and 1 man, suffering from pain in the face which satisfied the criteria of what has been called primary atypical facial neuralgia, were studied physically and psychologically. In no instance was any physical explanation for the pain discovered. On the other hand every patient proved to be seriously psychologically ill and the face pain was established to be an hysterical conversion symptom. All but 1 patient suffered from a variety of other symptoms many of which also proved to be hysterical in origin. Uniformly the patients presented a consistent character structure, best designated by the term masochistic. While not all the patients warranted the clinical diagnosis of conversion hysteria (although the face pain was a conversion symptom) all the patients showed to varying degrees this character disorder marked by many varieties of self-punitive behavior.

The genesis of pain as an hysterical conversion symptom is briefly discussed.

It is recommended that the term primary atypical facial neuralgia be abandoned and that in its place the term hysterical face pain be used and that it be recognized as only one symptom of a more complex psychological disorder.