Pain is more widespread and referred to trigeminal areas in occipital neuralgia

Abstract

RESUMOObjetivo. Avaliar dor local e referida na neuralgia occipital. Método. Avaliação de prontuários de 32, 16 e 102 pacientes com neuralgia occipital, enxaqueca sem aura e enxaqueca tensional. Critérios para distúrbios craniomandibulares, bruxismo, dores de cabeça, questioná-rios e exame clinico. Resultados. As áreas mais frequentes de dor local e referida na neuralgia occipital foram as regiões temporal, frontal, occipital, sub-occipital, retro-orbitária, cervical e vertex (78,1%). Áre-as mais frequentes de dor local/referida na cefaleia tensional foram as regiões temporal e frontal bilateral em 65 pacientes (63,7%) e as regiões cervical, vertex, sub-occipital e parietal (21,6%). Áreas comuns de dor local e referida na cefaleia sem aura foramnas regiões temporal anterior direita, parietal e occipital, temporal anterior esquerda, parietal, frontal e cervical (62,5%). A mediana de zonas anatômicas com dor foram para neuralgia occipital 3,5; enxaqueca tensional 2,0; enxaqueca sem aura 2,0 e controles 0,5 (Kruskal-Wallis p<0,0001). Conclusão. A dor na neuralgia occipital foi mais difusa e mais locais anatô-micos foram relatados. A dor na enxaqueca sem aura foi menos difusa que na neuralgia occipital e mais difusa que na enxaqueca tensional a qual foi mais localizada, bilateral nas regiões temporal e frontal.Unitermos. Dor, Neuralgia, Cefaleia Comum, Cefaleia Tensional Citação. Molina OF, Santos ZC, Simião BR, Torres SMP, Marçal RL, Penoni VB. A dor é mais difusa e referida para áreas do trigêmeo na neuralgia occipital. ABSTRACTObjetctive. Evaluate local and referred pain in occipital neuralgia. Method. Charts review of 32 occipital neuralgia, 16 migraine without aura and 102 tension-type headache individuals, respectively. Criteria for craniomandibular disorders, bruxism, headaches. Questionnaires to assess pain sites and descriptors for headaches. Results. Common areas of local/referred pain in occipital neuralgia were the temporal, frontal, occipital, sub-occipital, retro-orbital, cervical and vertex (78.1% cases). Common areas of referred pain in tension-type headache were located in the bilateral temporal and frontal areas (65=63.7%). Other areas of referred pain in tension-type headache were the cervical, vertex, sub-occipital and parietal areas (21.6%). Common areas of local and referred pain in migraine (62.5%) were located in the right anterior temporal area, right anterior temporal, parietal and occipital, left anterior temporal and parietal area, frontal and cervical areas. The median of painful anatomic zones were occipital neuralgia 3.5, tension-type headache 2.0, migraine 2.0; and Controls 0.5 (Kruskal-Wallis statistics with post-test p<0.0001). Conclusions. Pain in occipital neuralgia was reported in a more widespread anatomic area and in more anatomic zones as compared to migraine and tension-type headache. The latter was reported usually bilaterally in the frontal and temporal areas.