scholarly journals Orofacial pain: basic mechanisms and implication for successful management

2003 ◽  
Vol 11 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Paulo César Rodrigues Conti ◽  
Richard A. Pertes ◽  
Gary M. Heir ◽  
Cibele Nasri ◽  
Harold V. Cohen ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Temporomandibular Disorders ◽  
Facial Pain ◽  
Orofacial Pain ◽  
Dental Pain ◽  
Medical Problem ◽  
Basic Knowledge ◽  
Successful Management ◽  
Long Period ◽  
The Status

Orofacial Pain is the field of dentistry devoted to the diagnosis and management of chronic, complex, facial pain and oromotor disorders. This specialty in dentistry has developed over a number of years out of the need for better understanding of a group of patients who somehow were not clearly suffering from dental pain disorders, but still did not seem to have a clearly defined medical problem. After a long period of treating patients based on the mechanicist aspect of the disease, our profession has realized the importance of basic knowledge and differencial diagnosis in order to proper manage these patients. This modification in the approach has caused severe changes in education as well as in clinical activities. Historically considered as a problem of occlusion, Orofacial Pain, including Temporomandibular Disorders (TMD) has recently reached the status of "Specialty" in Brazil. Therefore, this paper aims to discuss the main differences between musculoskeletal and neuropathic pain and the importance of basic knowledge to perform successful management.

Cranial neuralgias and persistent idiopathic facial pain

2020 ◽  
pp. 237-247
Author(s):  
Aydin Gozalov ◽  
Messoud Ashina ◽  
Joanna M. Zakrzewska
Keyword(s):  
Neuropathic Pain ◽  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Orofacial Pain ◽  
Treatment Modalities ◽  
Management Approach ◽  
Trigeminal Neuropathy ◽  
Facial Region ◽  
Persistent Idiopathic Facial Pain ◽  
Chronic Orofacial Pain

Orofacial pain is a complex problem and affects up to 7% of the population. Although trigeminal neuralgia has been considered the prime neuralgic condition in the facial region, other forms of neuropathic pain are now being more frequently recognized and require recognition and a different management approach. Many patients with chronic orofacial pain report numerous comorbidities, such as psychiatric or personality disorders, which significantly affect management. Various pain conditions present in the facial region. Some of them rarely present extra-orally (unless as radiating pain) such as atypical odontalgia or persistent dento-alveolar pain disorder and burning mouth syndrome, whereas others will present in both areas such as classical trigeminal neuralgia, post-traumatic trigeminal neuropathy, trigeminal neuropathy attributed to multiple sclerosis, and persistent idiopathic facial pain. Myofascial pain syndrome related to the muscles of mastication is very common and may also be associated with temporomandibular joint problems. Trigeminal neuralgia and the rarer glossopharyngeal neuralgia are similar in quality and characteristics with specific treatment modalities, but differ in pain location. Trigeminal neuropathic pain is caused most frequently by trauma. If no other diagnostic criteria are fulfilled, a diagnosis of persistent idiopathic facial pain is made. It is crucial for these patients to be managed by multidisciplinary teams.

Difficult diagnosis of facial pain: A case report and mini-review

2010 ◽  
Vol 1 (4) ◽  
pp. 179-183 ◽  
Author(s):  
Satu K. Jääskeläinen ◽  
Heli Forssell ◽  
Olli Tenovuo ◽  
Riitta Parkkola
Keyword(s):  
Neuropathic Pain ◽  
Case Report ◽  
Facial Pain ◽  
Orofacial Pain ◽  
Brain Mri ◽  
Correct Diagnosis ◽  
Mouth Opening ◽  
Nerve Fibers ◽  
Sampling Errors ◽  
Myelinated Nerve

AbstractThis case report elucidates pitfalls of clinical and radiologic investigations of neuropathic pain due to trigeminal pathology, and utility of neurophysiologic examination when diagnosing facial pain. Our patient was a 63-year-old woman who developed acute, severe facial pain, first located behind the left eye. Neuralgic exacerbations, paresthesia within lower face on the left and restricted mouth opening occurred during the course of the disease with gradual progression. Brain MRI and CT scans were interpreted as normal at 4 and 10 months after symptom onset. At 9 months, detailed neurophysiologic examination showed severe chronic mandibular neuropathy at the left oval foramen with more prominent disturbance of the thick myelinated nerve fibers than the small fibers suggesting compressive etiology. Guided by the neurophysiologic findings, 11 months after the onset of the symptoms, a new brain MRI with contrast enhancement revealed metastatic adenocarcinoma of the left temporal bone along the mandibular nerve, exactly matching the site indicated by the neurophysiologic examination. Neurophysiologic tests offer cost-effective, sensitive tools for screening and accurate level diagnostics of neuropathy and neuropathic pain, which can be utilized also in the diagnosis of facial pain. In addition, whenever there are progressing neurologic deficits or neurophysiologic signs indicating expansive lesion, despite initially normal findings in the brain imaging studies, repeated MRI examinations are warranted, preferably focusing to the ‘neurophysiologic region of interest’ to avoid radiologic sampling errors. As no isolated technique achieves 100% diagnostic accuracy, only rational combinations of different methods will result in correct diagnosis of facial pain without unnecessary delays. Treatment of neuropathic pain is often delayed because of difficulties in reaching the correct diagnosis. During the work-up, many differential diagnostic alternatives have to be considered, also in patients with chronic orofacial pain. Table 1 shows the most important differential diagnoses of orofacial pain.

Chronic Facial Pain

2016 ◽  
Vol 5 (1) ◽  
pp. 26-29
Author(s):  
Martyn Ormond ◽  
Shalini Nayee ◽  
Tim Poate
Keyword(s):  
Facial Pain ◽  
Orofacial Pain ◽  
Correct Diagnosis ◽  
Successful Management ◽  
Biopsychosocial Approach ◽  
Common Complaint ◽  
Dental Procedures ◽  
Number Of Patients ◽  
Chronic Orofacial Pain

Orofacial pain is a common complaint with the vast majority of cases the result of an acute dental cause. There are, however, a number of patients who experience chronic orofacial pain in whom no dental cause can be found, and it is therefore important to identify these patients in order to avoid unnecessary dental procedures. Successful management of chronic orofacial pain depends on the correct diagnosis and appropriate interventions with a biopsychosocial approach.

Chronic neuropathic facial pain associated with cranial nerves damage: clinical picture, diagnosis, treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 42-45
Author(s):  
T. G. SAKOVETS ◽  
◽  
E. I. BOGDANOV ◽  
Keyword(s):  
Neuropathic Pain ◽  
Herpes Zoster ◽  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Orofacial Pain ◽  
Cranial Nerves ◽  
Ear Canal ◽  
Short Term ◽  
Adequate Treatment ◽  
Hunt Syndrome

The purpose — to study of the features of chronic neuropathic facial pain associated with cranial nerve damage. Material and methods. We studied the modern works on the features of the clinic, diagnosis and treatment of chronic orofacial pain caused the cranial nerves damage. Special attention was paid to the methods of diagnosing neuropathic facial pain of various etiologies, and identifying clinical variants of their course. Results. The best known and most common variant of neuropathic orofacial pain is trigeminal neuralgia. There are classic trigeminal neuralgia that occurs as a result of vaso-neural conflict, secondary trigeminal neuralgia (in multiple sclerosis, voluminous brain neoplasm, etc.), and idiopathic trigeminal neuralgia. Patients have short-term (from fractions of a second to 2 minutes) unilateral paroxysmal facial pain in classic trigeminal neuralgia. In case of secondary trigeminal neuralgia, mainly bilateral neuropathic pain is detected. Painful trigeminal neuropathy (trigeminal neuropathic pain other than trigeminal neuralgia) is caused by trauma and herpes zoster with acute neuropathic pain. After 3 months, painful manifestations after the herpes zoster are qualified as trigeminal postherpetic neuralgia. Post-traumatic neuropathic trigeminal pain is the result of external trauma or iatrogenic damage resulting from dental treatment or neuroablation procedures. Both classical and secondary, idiopathic neuralgia of the glossopharyngeal nerve is characterized by unilateral short-term stabbing pain in the ear, base of the tongue, tonsil region, posterior part of the pharynx; it is less common, in contrast to trigeminal neuralgia. Intermediate nerve neuralgia was first described in 1907 by Hunt; it is rare, manifests itself as unilateral, shooting, paroxysmal pain in the ear canal and temporal areas. Painful neuropathy of the intermediate nerve (Ramsey — Hunt syndrome) with herpes zoster is characterized by dull, persistent pain that occurs inside the ear canal, auricle or mastoid. Rarely, tumors of the face can be the cause of Ramsey — Hunt syndrome. Conclusion. Thus, chronic neuropathic facial pain associated with facial nerves damage has a varied etiology, which requires careful differential diagnosis and selection of adequate treatment tactics.

Orofacial pain

2020 ◽  
pp. 399-402
Author(s):  
Steven B. Graff-Radford ◽  
Alan C. Newman
Keyword(s):  
Neuropathic Pain ◽  
Temporomandibular Disorders ◽  
Soft Tissues ◽  
Orofacial Pain ◽  
Myofascial Pain ◽  
Shared Responsibility ◽  
Diagnosis And Treatment ◽  
Primary Headaches ◽  
Cervical Pain ◽  
And Training

Orofacial pain involves pain conditions associated with the hard and soft tissues of the head, face, neck, and all the intra-oral structures. The field of orofacial pain encompasses diagnosis and treatment of primary headaches, temporomandibular disorders, neuropathic pain, cervical pain, and myofascial pain. The evaluation and treatment of orofacial pain has evolved into a shared responsibility between the dentist and physician, with considerable overlap, distinguished only by the practitioner’s knowledge and training.

scholarly journals Neuralgias of the Trigeminal Nerve

2000 ◽  
Vol 5 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Allan S Gordon
Keyword(s):  
Neuropathic Pain ◽  
Differential Diagnosis ◽  
Trigeminal Neuralgia ◽  
Clinical Features ◽  
Trigeminal Nerve ◽  
Postherpetic Neuralgia ◽  
Facial Pain ◽  
The Other ◽  
Atypical Facial Pain ◽  
Trigeminal Neuropathic Pain

Practitioners are often presented with patients who complain bitterly of facial pain. The trigeminal nerve is involved in four conditions that are sometimes mixed up. The four conditions - trigeminal neuralgia, trigeminal neuropathic pain, postherpetic neuralgia and atypical facial pain - are discussed under the headings of clinical features, differential diagnosis, cause and treatment. This article should help practitioners to differentiate one from the other and to manage their care.

scholarly journals Oral infections and orofacial pain in Alzheimer's disease: case report and review

2010 ◽  
Vol 4 (2) ◽  
pp. 145-150 ◽  
Author(s):  
Silvia Regina Dowgan T. de Siqueira ◽  
Thaís de Souza Rolim ◽  
Manoel Jacobsen Teixeira ◽  
Ricardo Nitrini ◽  
Renato Anghinah ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Facial Pain ◽  
Orofacial Pain ◽  
The Elderly ◽  
Secondary Headache ◽  
Behavioral Impairment ◽  
Common Cause ◽  
Oral Infections ◽  
Disease Case

Abstract Dental infections, frequent in the general population, are a common cause of inflammation with systemic impact, and are the most common cause of orofacial pain. Temporomandibular disorders are also frequent in the elderly and represent an important cause of secondary headache. Both inflammation and pain can also contribute to cognitive, functional and behavioral impairment of the elderly and aggravate symptoms of patients with Alzheimer's disease (AD). We report a case of a 74-year-old woman with AD and chronic facial pain who had a significant improvement in functional activities as well as in cognition and depressive symptoms after successful treatment of her facial pain. Patients with AD have higher compromise of oral health with infections and teeth loss. The investigation of orofacial pain should be performed in patients with AD, because of the associations reviewed and given the potential for improvement as highlighted by this case.

scholarly journals Paroxysmal Neuralgia in Pediatric Population- A Diagnostic Dilemma for Physicians and Dental Practioners

2014 ◽  
Vol 10 (4) ◽  
pp. 74-77 ◽  
Author(s):  
A Dubey ◽  
S Mujoo ◽  
SB Sakarde ◽  
AK Dubey
Keyword(s):  
Neuropathic Pain ◽  
Orofacial Pain ◽  
Pediatric Population ◽  
Treatment Strategies ◽  
Diagnostic Dilemma ◽  
Dental Pathology ◽  
Dental Intervention

Paroxysmal neuralgia is relatively uncommon in children. Neuropathic orofacial pain is a challenge for the clinician, as no obvious dental pathology exists either clinically or radiographically. Dentist and physician should be able to recognize the characteristics of neuropathic pain so as to correctly diagnose these conditions hence avoid unnecessary dental intervention. This article reviews the conditions with paroxysmal neuralgia in children and available treatment strategies. DOI: http://dx.doi.org/10.3126/kumj.v10i4.11000 Kathmandu Univ Med J 2012;10(4):74-77

scholarly journals Linguistic culture and politics in France

enadakultura ◽  
2021 ◽  
Author(s):  
Natalia Revishvili
Keyword(s):  
French Revolution ◽  
French Language ◽  
National Politics ◽  
The Public ◽  
French Academy ◽  
Long Period ◽  
The Status ◽  
Classical Language ◽  
High Level ◽  
Public Instruction

The rise of the French national politics was taking place simultaneously with the rise of the French power and territories in Europe. The first evidence of the emergence of the French language distinguished from Latin is the text of the ‘’French’’ version of the 842-nd Strasbourg Oath. France is an example of how ideas and myths about a language become ideologies and how it forms a part of a language policy, along with language planning and language practices.The French language was being established over a long period of time. From the 17th century onwards, increasing attention was paid to this issue. It is especially interesting to establish a high level of French spelling, the expression of good spelling in the French language has become an object of social values. On October 19 and 20, 1794, the Public Instruction Committee introduced a new project to teach French to all. French became the language of writing before it set foot in education.The 17-th and 18-th centuries became a period of legalization of the French language. The greatest philosophers and writers of this time legalized the French language in poetry and fiction. At the same time, it became the language of scientific writing. French gained the status of the most brilliant language in Europe over the last two centuries through the French Academy and the French Revolution. It was a new ‘’classical“ language.

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