Craniofacial pain

2011 ◽  
Author(s):  
John Scadding
Keyword(s):  
Facial Pain ◽  
Headache Disorders ◽  
Oral Medicine ◽  
Detailed History ◽  
Medicine Physician ◽  
Good Guide ◽  
Craniofacial Pain ◽  
Tissue Of Origin ◽  
The Many ◽  
Nose And Throat

Craniofacial pain, excluding the headache disorders, comprises a heterogeneous group of conditions. Some fall within the sphere of the neurologist, but many call for other specialist skills in diagnosis and management. The site of pain is not always a good guide to either the nature of the pain or the tissue of origin. Patients with craniofacial pain are frequently referred to the neurologist on an assumption that the pain is neuralgic, and for this reason neurologists need to be aware of the many potential causes and be prepared to collaborate closely with other specialists, including the ear, nose, and throat surgeon, ophthalmologist, dental surgeon, oral medicine physician, and psychiatrist. An accurate and detailed history is essential, because in many patients with facial pain, there will be no abnormal physical signs and the diagnosis rests entirely on the history.

scholarly journals Facial presentations of primary headache disorders

Cephalalgia ◽  
2017 ◽  
Vol 37 (7) ◽  
pp. 714-719 ◽  
Author(s):  
Yair Sharav ◽  
Zaza Katsarava ◽  
Andrew Charles
Keyword(s):  
Facial Pain ◽  
Signs And Symptoms ◽  
Primary Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Cranial Autonomic Symptoms ◽  
Dental Pathology ◽  
Craniofacial Pain ◽  
Sound Sensitivity ◽  
Distinguishing Features

Background Many patients with mid-face or lower face craniofacial pain are diagnosed, based on accompanying signs and symptoms and features other than location, as either atypical migraines or atypical TACs. Distinguishing features of headache disorders as a cause of facial pain include the temporal pattern of pain, associated symptoms including light and sound sensitivity and nausea, cranial autonomic symptoms, and the lack of local triggering among others. Results An intraoral neurovascular pain has been observed, and was termed neurovascular orofacial pain (NVOP). Due to its location, and signs imitating dental pulpitis, it has great diagnostic and therapeutic importance for differentiating NVOP from dental pathology. The hypothesized mechanism is neurogenic inflammatory activation within the space confined by dentine around the dental pulp, expressed in strong paroxysmal pain and typical allodynia to cold foods. Conclusion Facial manifestations of headache disorders and primary facial pain disorders share common trigeminal nerve input, yet they are highly distinct disorders. Somatotopic segregation may occur at the level of the trigeminal nucleus, thalamus, and somatosensory cortex, and distinct ionic or neurochemical signaling pathways may be involved. Further investigation of facial presentations of headache disorders has the potential to provide new insight into the interface between headache and facial pain.

scholarly journals Reference programme: diagnosis and treatment of headache disorders and facial pain. Danish Headache Society, 3rd edition, 2020

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Henrik W. Schytz ◽  
Faisal M. Amin ◽  
Rigmor H. Jensen ◽  
Louise Carlsen ◽  
Stine Maarbjerg ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Facial Pain ◽  
Common Interest ◽  
Diagnosis And Treatment ◽  
Primary Headaches ◽  
Secondary Headache ◽  
Great Success ◽  
Headache Disorders

AbstractHeadache and facial pain are among the most common, disabling and costly diseases in Europe, which demands for high quality health care on all levels within the health system. The role of the Danish Headache Society is to educate and advocate for the needs of patients with headache and facial pain. Therefore, the Danish Headache Society has launched a third version of the guideline for the diagnosis, organization and treatment of the most common types of headaches and facial pain in Denmark. The second edition was published in Danish in 2010 and has been a great success, but as new knowledge and treatments have emerged it was timely to revise the guideline. The recommendations for the primary headaches and facial pain are largely in accordance with the European guidelines produced by the European Academy of Neurology. The guideline should be used a practical tool for use in daily clinical practice for primary care physicians, neurologists with a common interest in headache, as well as other health-care professionals treating headache patients. The guideline first describes how to examine and diagnose the headache patient and how headache treatment is organized in Denmark. This description is followed by sections on the characteristics, diagnosis and treatment of each of the most common primary and secondary headache disorders and trigeminal neuralgia. The guideline includes many tables to facilitate a quick overview. Finally, the particular challenges regarding migraine and female hormones as well as headache in children are addressed.

scholarly journals Facial Pain: A Comprehensive Review and Proposal for a Pragmatic Diagnostic Approach

2020 ◽  
Vol 83 (1) ◽  
pp. 5-16 ◽  
Author(s):  
Laura Van Deun ◽  
Muriel de Witte ◽  
Thaïs Goessens ◽  
Stijn Halewyck ◽  
Marie-Christine Ketelaer ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Classification System ◽  
Facial Pain ◽  
Correct Diagnosis ◽  
Headache Disorders ◽  
Comprehensive Review ◽  
Pain Condition ◽  
Throat Pain ◽  
Generic Framework

Background: Facial pain, alone or combined with other symptoms, is a frequent complaint. Moreover, it is a symptom situated at, more than any other pain condition, a crosspoint where several disciplines meet, for example, dentists; manual therapists; ophthalmologists; psychologists; and ear-nose-throat, pain, and internal medicine physicians besides neurologists and neurosurgeons. Recently, a new version of the most widely used classification system among neurologists for headache and facial pain, the International Classification of Headache Disorders, has been published. Objective: The aims of this study were to provide an overview of the most prevalent etiologies of facial pain and to provide a generic framework for the neurologist on how to manage patients presenting with facial pain. Methods: An overview of the different etiologies of facial pain is provided from the viewpoint of the respective clinical specialties that are confronted with facial pain. Key message: Caregivers should “think outside their own box” and refer to other disciplines when indicated. If not, a correct diagnosis can be delayed and unnecessary treatments might be given. The presented framework is aimed at excluding life- or organ-threatening diseases, providing several clinical clues and indications for technical investigations, and ultimately leading to the correct diagnosis and/or referral to other disciplines.

Oral Medicine Considerations for Older Patients

2020 ◽  
Vol 9 (3) ◽  
pp. 45-53
Author(s):  
Jayne Patterson ◽  
Amanda Willis
Keyword(s):  
General Practice ◽  
Oral Cavity ◽  
Older Patients ◽  
Facial Pain ◽  
Healthcare Professionals ◽  
Significant Problem ◽  
Oral Medicine ◽  
Mucosal Disease ◽  
Older Populations

With the projected increase to 1.3 billion people aged 65 years or older by 2040, healthcare professionals are faced with significant challenges in managing this population of patients. In the oral cavity, oral mucosal disease is a significant problem found in older populations. Several facial pain conditions are more likely to be seen in this cohort of patients. Although management of this group of patients may not always be appropriate in general practice, an awareness of the range of oral medicine conditions that may be encountered in older patients is essential to allow prompt referral and treatment.

scholarly journals Two Immigrants with Tuberculosis of the Ear, Nose, and Throat Region with Skull Base and Cranial Nerve Involvement

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Renate A. Richardus ◽  
Jeroen C. Jansen ◽  
Stefan C. A. Steens ◽  
Sandra M. Arend
Keyword(s):  
Differential Diagnosis ◽  
Skull Base ◽  
Retropharyngeal Abscess ◽  
Review Of The Literature ◽  
Abducens Palsy ◽  
Cranial Nerve Involvement ◽  
Throat Region ◽  
The Many ◽  
Nose And Throat ◽  
Acid Fast Staining

We report two immigrants with tuberculosis of the skull base and a review of the literature. A Somalian man presented with bilateral otitis media, hearing loss, and facial and abducens palsy. Imaging showed involvement of both mastoid and petrous bones, extending via the skull base to the nasopharynx, suggesting tuberculosis which was confirmed by characteristic histology and positive auramine staining, while Ziehl-Neelsen staining and PCR were negative. A Sudanese man presented with torticollis and deviation of the uvula due to paresis of N. IX and XI. Imaging showed a retropharyngeal abscess and lysis of the clivus. Histology, acid-fast staining, and PCR were negative. Both patients had a positive Quantiferon TB Gold in-tube result and improved rapidly after empiric treatment for tuberculosis. Cultures eventually yieldedM. tuberculosis. These unusual cases exemplify the many faces of tuberculosis and the importance to include tuberculosis in the differential diagnosis of unexplained problems.

scholarly journals Neurostimulation for the Treatment of Chronic Head and Facial Pain: A Literature Review

2019 ◽  
Vol 5 (22;5) ◽  
pp. 447-477
Author(s):  
Ajay Antony
Keyword(s):  
Peripheral Nerve ◽  
Cluster Headache ◽  
Nerve Stimulation ◽  
Facial Pain ◽  
Current Evidence ◽  
Occipital Neuralgia ◽  
Occipital Nerve Stimulation ◽  
Peripheral Nerve Stimulator ◽  
Occipital Nerve ◽  
Craniofacial Pain

Background: Head and facial pain is a common and often difficult to treat disorder. Routine treatments sometimes fail to provide acceptable relief, leaving the patient searching for something else, including narcotics and surgery. Recently, neuromodulation has been expanding to provide another option. Secondary to its potentially temporary nature and relatively manageable risk profile, several reviews have suggested trialing neuromodulation prior to starting narcotics or invasive permanent surgeries. There is evidence that neuromodulation can make a difference in those patients with intractable severe craniofacial pain. Objectives: To provide a basic overview of the anatomy, epidemiology, pathophysiology and common treatments of several common head and facial disorders. Furthermore, to demonstrate the suggested mechanisms of neuromodulation and the evidence currently existing for the use of neuromodulation. Methods: A comprehensive review was performed regarding the available literature through targeting articles reporting on the use of neuromodulation to treat pain of the head and face. Results: We compiled and discuss the current evidence available in treating head and facial pain. The strongest evidence currently for neuromodulation is for occipital nerve stimulation for migraine, transcutaneous vagal nerve stimulation for migraine and cluster headache, sphenopalatine ganglion microstimulation for cluster headache, and transcutaneous supraorbital and supratrochlear nerve stimulation for migraine. In addition, there is moderate evidence for occipital nerve stimulation in treating occipital neuralgia. Limitations: Neuromodulation has been trialed and is promising in several craniofacial pain disorders; however, there remains a need for large-scale, randomized, placebo-controlled clinical trials to further evaluate the efficacy and safety of most treatments. Much of the current data relies on case reports without randomization or placebo controls. Conclusions: With advancing techniques and technology, neuromodulation can be promising in treating intractable pain of the head and face. Although more randomized controlled trials are warranted, the current literature supports the use of neuromodulation in intractable craniofacial pain. Key words: Neuromodulation, headache, facial pain, craniofacial pain, migraine, cluster headache, trigeminal neuralgia, occipital neuralgia, peripheral nerve stimulator, high cervical spinal cord stimulator, peripheral nerve field stimulator

scholarly journals Unilateral Eagle’s Syndrome

2022 ◽  
Vol 40 (1) ◽  
pp. 72-74
Author(s):  
Md Talal Mamun ◽  
Rahat Amin Chowdhury
Keyword(s):  
Facial Pain ◽  
Adult Population ◽  
Common Factor ◽  
Styloid Process ◽  
Principal Factor ◽  
Transoral Approach ◽  
Eagle’S Syndrome ◽  
Detailed History ◽  
Elongated Styloid Process ◽  
Stylohyoid Ligament

Eagle’s syndrome represent as a neck, cervicofacial pain, dysphagia, facial pain, globus sensation, tinnitus, otalgia and headache, it may be unilateral or bilateral. About 4% of adult population accounted elongated styloid process, which are the principal factor of Eagle’s syndrome and followed by 0.16% of patients are symptomatic. Stylohyoid ligament calcification is the second most common factor. The diagnosis must be made through a detailed history, clinical examination, and various imaging modalities. A 36 years old female patient presented with persistent pain in the throat. An elongated styloid process was diagnosed and was removed by transoral approach following the patient was relieved from her symptoms. J Bangladesh Coll Phys Surg 2022; 40: 72-74

scholarly journals Possible Uses of Plants of the Genus Asphodelus in Oral Medicine

Biomedicines ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 67 ◽  
Author(s):  
Dioguardi ◽  
Campanella ◽  
Cocco ◽  
Arena ◽  
Malagnino ◽  
...  
Keyword(s):  
North Africa ◽  
Web Of Science ◽  
Scientific Literature ◽  
Mediterranean Area ◽  
Oral Medicine ◽  
Microbial Diseases ◽  
Eligibility Criteria ◽  
Antitumor Properties ◽  
The Many ◽  
Antioxidant Effects

Among the many plants used in traditional medicine we have the plants of the genus Asphodelus, which are present in the Mediterranean area in North Africa and South East Asia, and have been used by indigenous peoples until recently for various pathologies, including: Psoriasis, alopecia areata, acne, burns, nephrolithiasis, toothache, and local inflammation. The scientific literature over the last five years has investigated the various effects of the metabolites extracted from plants of the genus Asphodelus, paying attention to the diuretic, antihypertensive, antimicrobial, anti-inflammatory, and antioxidant effects, and it also has begun to investigate the antitumor properties on tumor cell lines. Studies have been identified through bibliographic research on electronic databases. A total of 574 records were identified on the PubMed, Scopus, Web of Science, and EBSCO databases. After having proceeded to the screening of the articles with the application of the eligibility criteria (all the articles pertaining to the issue Asphodelus), we arrived at a number of 163 articles, and then after the elimination of overlaps, to 82 articles. There are 11 articles which investigate the possible uses of plants of the genus Asphodelus in oral medicine. In oral medicine, the possible uses investigated by the scientific literature are for the treatment of neoplastic (melanoma and oral cancer), viral (herpetic viruses), and microbial diseases (candida, bacteriosis, leishmaniasis), and in the affection of the skin.

scholarly journals Diode Laser for Laryngeal Cancer: “980 nm” and Beyond the Classic CO2

2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 19S-23S
Author(s):  
Petros D. Karkos ◽  
Ioannis Koskinas ◽  
Marios Stavrakas ◽  
Stefanos Triaridis ◽  
Jannis Constantinidis
Keyword(s):  
Diode Laser ◽  
Lower Cost ◽  
New Technology ◽  
Oncologic Outcome ◽  
Guidance System ◽  
Medical Specialties ◽  
Flexible Fiber ◽  
Straight Beam ◽  
The Many ◽  
Nose And Throat

Lasers have been used in otolaryngology for more than 40 years and are widely considered an established way of addressing laryngeal pathology, benign and malignant. Carbon dioxide (CO2) laser is considered a gold standard, but over the last 2 decades, a new technology has been developed and established in other medical specialties, not so much in Ear Nose and Throat (ENT), the diode laser. It consists of a flexible fiber that passes through a hollow guidance system and is capable of reaching certain angled spots easier than straight beam systems. Portability, lower cost, easier setup, and improved photocoagulation are just some of the many features rendering it an excellent choice for the surgeon and the patient. The few studies published worldwide for the usage and efficacy of this system show no major differences related to the oncologic outcome and survival rate of patients having an early glottic tumor between diode laser microsurgery and CO2 laser cordectomy. Nevertheless, the advantages offered by fiber-optic laser surgery render it a worthy and perhaps equal alternative for treating this kind of pathology.

Persistent Idiopathic Facial Pain

2018 ◽  
pp. 279-286
Author(s):  
Trevor Van Oostrom
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Criteria ◽  
Psychological Factors ◽  
Facial Pain ◽  
Treatment Options ◽  
Headache Disorders ◽  
Diagnostic Challenge ◽  
Persistent Idiopathic Facial Pain ◽  
Case Based

Persistent idiopathic facial pain (PIFP) is an enigmatic condition which has caused a great deal of suffering yet has been difficult to define and remains a challenging disorder to treat. In addition, the presentation of PIFP has considerable overlap with many other causes of facial pain making the malady a diagnostic challenge. The condition is often resistant to treatment and patients often have comorbid syndromes or psychological factors. This chapter reviews the history and development of the current diagnostic criteria of PIFP according to the latest edition of the International Classification of Headache Disorders (ICHD). Using a case-based approach, the pathophysiology, epidemiology, differential diagnosis, and treatment options of PIFP are explored.

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