Primary auriculotemporal neuralgia. Case report

Abstract

BACKGROUND AND OBJECTIVES:Auriculotemporal neuralgia is an uncommon condition. Symptoms are brief severe pain attacks, especially in the temporal region. Although many cranial neuralgias are related to nervous compression, they may be present without identifiable etiologic factors. This study aimed at describing a case of primary auriculotemporal neuralgia and respective therapeutic approach. CASE REPORT: Male patient, 72 years old, presented for assistance reporting severe pain in left temporal region, described as shock and of very short duration. After clinical evaluation and imaging exams, no significant changes were detected. Patient has satisfactorily responded to carbamazepine. CONCLUSION: This case shows that auriculotemporal neuralgia has clinical presentation similar to other neuralgias. Diagnosis is primarily obtained by pain characteristics evaluation and exclusion of possible secondary causes. Keywords: Auriculotemporal nerve, Auriculotemporal neuralgia, Neuropathic pain. RESUMO JUSTIFICATIVA E OBJETIVOS:A neuralgia do aurículotem-poral é uma condição rara. Os sintomas consistem em ataques de dor intensa, de curta duração, sobretudo na região temporal. Embora muitos casos de neuralgias cranianas sejam relacionados à compressão nervosa, podem ocorrer sem fatores etiológicos identificáveis. O objetivo deste estudo foi descrever um caso de neuralgia auriculotemporal primária e respectiva conduta terapêutica. RELATO DO CASO: Paciente do gênero masculino, 72 anos, compareceu para atendimento relatando dor intensa em região temporal esquerda, descrita como choque, de curtíssima duração. Após avaliação clínica e exames de imagens, não foram detectadas alterações significativas. O paciente respondeu de forma satisfatória à carbamazepina. Primary auriculotemporal neuralgia. Case report

Botulinum Toxin Type A for the Treatment of Auriculotemporal Neuralgia—A Case Series

“…Nevertheless, the duration of the effect was short (24 h-10 days). ATN is a rare disorder and treatments proposed in the literature are not evidence-based; therefore, most clinicians prescribe medications used in other forms of neuralgia, such as gabapentin or carbamazepine [9][10][11][12]; in our cohort, the patients that were on medications had no significant pain relief with these drugs. Treatment with BoNT/A injections had been previously reported in only one case of ATN with satisfactory results [18].…”

“…Speciali et al described six patients with ATN in 2005 [9]; all the patients were female and all of them had unilateral pain which worsened with palpation over the preauricular region, with secondary pain radiation toward the mandible in all cases, and toward the occipital region in four cases. The presence of concomitant background pain is not uncommon [10][11][12]. Ruiz et al reported eight patients with ATN: two patients had only background pain, two patients had both background pain and paroxysmal stabbing pain, while the last four patients only had paroxysmal pain (two of them had stabbing pain, one had shock-like pain and one had throbbing pain); exacerbation pain lasted from 2 s to 30 min and was mainly localized in the temporal, preauricular, and periauricular regions, but there was also hemicraneal and lateral neck localization and/or pain radiation.…”

“…Ruiz et al reported eight patients with ATN: two patients had only background pain, two patients had both background pain and paroxysmal stabbing pain, while the last four patients only had paroxysmal pain (two of them had stabbing pain, one had shock-like pain and one had throbbing pain); exacerbation pain lasted from 2 s to 30 min and was mainly localized in the temporal, preauricular, and periauricular regions, but there was also hemicraneal and lateral neck localization and/or pain radiation. In 2015, Kosminsky et al described another case of ATN [12]; they also reported that they treated other five patients with ATN (six patients in total and five of them had persistent pain).…”

Pulsed Radiofrequency for Auriculotemporal Neuralgia: A Case Report

“…Auriculotemporal neuralgia (ATN) is a rare disorder involving 0.23–0.4% of the patients in tertiary headache centers, characterized by unilateral side-locked pain localized in the territory of the auriculotemporal nerve [ 1 , 2 , 3 , 4 ]. The pain could be paroxysmal, moderate to severe in intensity, and variable in duration; however, continuous pain is often seen in this scenario.…”