Diferential diagnosis in atypical facial pain: a clinical study

Nóbrega, José Cláudio Marinho da; Siqueira, Sílvia Regina Dowgan Tesseroli de; Siqueira, José Tadeu Tesseroli de; Teixeira, Manoel Jacobsen

doi:10.1590/s0004-282x2007000200013

Cited by 44 publications

(30 citation statements)

References 17 publications

(6 reference statements)

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“…It is important for all patients with facial pain to explain their diagnosis 16 . TN was well understood by the patients that participated in this study, but currently it is common to find iatrogenic procedures as dental treatments 9,17 .…”

Section: Discussionmentioning

confidence: 99%

“…Temporomandibular disorder (TMD) is a general term for musculoskeletal pain of the masticatory system with multiple etiology. It is one of the most common diagnosis of chronic orofacial pain, associated to pychosocial, behavioral, cognitive and emotional factors 9 , and patients often have depression and/ or anxiety. Beyond physical abnormalities at the muscles and at the teeth and joints, emotional stress is also associated 10 , and psychological assistance is necessary for most of the patients 11 .…”

Section: Dra Silvia Regina Dowgan Tesseroli De Siqueira -Rua Carlos mentioning

confidence: 99%

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Psychological evaluation and cope with trigeminal neuralgia and temporomandibular disorder

Castro

Siqueira

Perissinotti

et al. 2008

Arq. Neuro-Psiquiatr.

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-Objective:To determine the psychological aspects of orofacial pain in trigeminal neuralgia (TN) and temporomandibular disorder (TMD), and associated factors of coping as limitations in daily activities and feelings about the treatment and about the pain. Method: 30 patients were evaluated (15 with TN and 15 with TMD) using a semi-directed interview and the Hospital Anxiety Depression (HAD) scale. Results: TN patients knew more about their diagnosis (p<0.001). Most of the patients with TN considered their disease severe (87%), in opposite to TMD (p=0.004); both groups had a high level of limitations in daily activities, and the most helpful factors to overcome pain were the proposed treatment followed by religiosity (p<0.04). Means of HAD scores were 10.9 for anxiety (moderate) and 11.67 for depression (mild), and were not statistically different between TMD and NT (p=0.20). Conclusion: TN and TMD had similar scores of anxiety and depression, therefore patients consider TN more severe than TMD. Even with higher limitations, patients with TN cope better with their disease then patients with TMD.KEy worDs: trigeminal neuralgia, TMD, surgery, orofacial pain, anxiety, depression, disease perception. avaliação psicológica e enfrentamento na neuralgia trigeminal e disfunção temporomandibularResumo -Objetivo: Comparar aspectos psicológicos de dor orofacial entre neuralgia trigeminal (NT) e disfunção temporomandibular (DTM), e repercussões em atividades diárias, enfrentamento a representação da dor. Método: 30 pacientes foram avaliados (15 com NT, 15 com DTM) utilizando entrevista semi-dirigida e a Escala Hospitalar de Ansiedade e Depressão (HAD). Resultados: Pacientes com NT sabiam melhor sobre seu diagnóstico (p<0,001). A maioria destes considerou sua doença grave (87%), em oposição a pacientes com DTM (p=0,004); ambos tiveram um alto nível de limitações durante atividades diárias, e o tratamento seguido da religiosidade foram considerados os aspectos mais positivos para superação da dor (p<0,04). Não houve diferença estatística entre os grupos quanto a HAD (p=0,20), sendo a média dos índices foi 10,9 para ansiedade (moderada) e 11,67 para depressão (leve). Conclusão: Tanto pacientes com NT como pacientes com DTM apresentaram níveis semelhantes de ansiedade e depressão, entretanto pacientes com NT consideram sua doença mais grave do que os outros doentes. Mesmo com alto grau de limitações, seu enfrentamento da doença é melhor do que o enfrentamento de doentes com DTM.PAlAvrAs-CHAvE: neuralgia trigeminal, DTM, cirurgia, dor orofacial, ansiedade, depressão, representação da doença.

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Section: Discussionmentioning

confidence: 99%

Section: Dra Silvia Regina Dowgan Tesseroli De Siqueira -Rua Carlos mentioning

confidence: 99%

Psychological evaluation and cope with trigeminal neuralgia and temporomandibular disorder

Castro

Siqueira

Perissinotti

et al. 2008

Arq. Neuro-Psiquiatr.

Self Cite

View full text Add to dashboard Cite

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“…However, there were several positive correlations among the different modalities (cold, tactile, warm, and pain); the mechanisms underlying it might involve central processing of sensorial modalities, discrete impairment or sensory losses can occur in association 30 .…”

Section: Correlations Among Variablesmentioning

confidence: 99%

Quantitative sensory testing in trigeminal traumatic neuropathic pain and persistent idiopathic facial pain

Siqueira

Siviero

Alvarez

et al. 2013

Arq. Neuro-Psiquiatr.

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The objective of this article was to investigate, with a systematic protocol of quantitative sensory testing, patients with persistent idiopathic facial pain (PIFP) and others with trigeminal traumatic neuropathic pain (TTN) compared to controls. Thirty patients with PIFP, 19 with TTN, and 30 controls were evaluated on subjective numbness and dysesthesia and with a systematic protocol of quantitative sensory testing for thermal evaluation (cold and warm), mechanical detection (touch and pinpricks for mechanical pain), superficial pain thresholds, and corneal reflex. We found that PIFP and TTN had numbness and dysesthesia higher than controls (p<0.001 and p=0.003), and that in both of them mechanical pain by pinpricks detection was abnormal intra and extra orally at the mandibular branch (p<0.001). Cold, warm, and tactile detections and pain thresholds were similar among the groups. Corneal reflex was abnormal in TTN (p=0.005). This study supports neuropathic mechanisms involving pain processing in PIFP and that the criterion on absence of sensorial variations in PIFP should be revised.

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“…8 These patients can be helped by being evaluated by more than one practitioner because of the wide array of symptoms causing difficulty with the differential diagnosis. 25 This may be why having more than one specialist treating a case with different viewpoints can potentially bring faster and more permanent resolution to a case. 26 This is also why advanced training may be advantageous to these providers.…”

Section: Discussionmentioning

confidence: 99%

A Collaborative Approach Between Chiropractic and Dentistry to Address Temporomandibular Dysfunction: A Case Report

Rubis¹,

Rubis²,

Winchester³

2014

Journal of Chiropractic Medicine

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Objective: The purpose of this case report is to describe the chiropractic and dental comanagement of a patient with temporomandibular dysfunction, headaches, and myalgia. Clinical features: A 38-year-old black female patient presented for chiropractic care with a chief concern of jaw pain, tinnitus, headaches, and neck and shoulder soreness of 8 months' duration. The patient rated the pain a 6/10. The patient had a maximum mouth opening of 42 mm, graphed evidence of disk displacement, loss of translation on opening of the right temporomandibular joint viewed on the lateral radiograph, and numerous areas of point tenderness on the Kinnie-Funt Chief Complaint Visual Index. She had decreased lateral cervical flexion. Intervention and outcome: Dental treatment consisted of an anterior repositioning splint. Chiropractic care consisted of Activator treatment to the pelvis and the thoracic and cervical spine. Manual manipulation of the temporomandibular joint was performed along with a soft tissue technique intraorally on the lateral pterygoid. Postisometric relaxation in the head and neck region was also done. The patient was treated 6 times over 3 weeks. At the end of treatment, the patient had a pain rating of 0/10, maximum mouth opening of 49 mm, no tender points on the follow-up Kinnie-Funt, and increased cervical range of motion. Conclusion: The patient demonstrated increased mouth opening, decreased pain rating, improved Kinnie-Funt visual index, and an increased cervical lateral flexion range of motion after 3 weeks of a combination of chiropractic and dental care.

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Diferential diagnosis in atypical facial pain: a clinical study

Abstract: AFP patients had more: a) traumatic events previously to pain onset, and b) emotions as a triggering factor for pain. These data support the need of trained health professionals in multidisciplinary groups for the accurate diagnosis and treatment of these patients.

Cited by 44 publications

References 17 publications

Psychological evaluation and cope with trigeminal neuralgia and temporomandibular disorder

Psychological evaluation and cope with trigeminal neuralgia and temporomandibular disorder

Quantitative sensory testing in trigeminal traumatic neuropathic pain and persistent idiopathic facial pain

A Collaborative Approach Between Chiropractic and Dentistry to Address Temporomandibular Dysfunction: A Case Report

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