Facial Pain: Difference between revisions

Revision as of 14:50, 12 September 2011

Primary causes of pain

Dentine sensitivity
pulpitis
periapical periodontitis
abscess
neuralgias

Neuralgias

Trigeminal neuralgia

sharp stabbing episodic electric shock like pain; lasts a few sec

trigger zone - stimulated by washin face/shaving etc.

Treated with carbamazepine 100mg 2x per day. Local anesthetic, injected to trigger zone can relief pain temporarily

Glossopharyngeal neuralgia

Posterolateral tongue + ear of affected side; stimuli -> eating, drinking, speaking

Preherpetic neuralgia

Aching, burning pain, limited to distribution of trigeminal nerve

Treated with high dose acyclovir

Postherpetic neuralgia

Unpleasant burning pain.

Blockade of stellate ganglion with bupivicaine (local anesthetic) (short term relief)

Pain of vascular origin

migraine

Intense persisting aching pain, unilateral; stimuli -> food, alcohol, stress, hormones, give painkillers

cluster headache

Intense aching pain that disturbs sleep, nasal congestion.

Stimuli : alcohol, vasodilators, high altitude.

Treat with ergotamine or sumatriptan.

Giant cell arteritis

Throbbing headache, unilateral, fever, malaise, weight loss, treated with high dose prednisolone.

Atypical orofacial pain

Gripping, vice like aching pain, feeling of pressure

Burning mouth syndrome

type 1 (not present on waking)
type 2 (present on waking)
type 3 - intermittent - Possible deficiency of vitamin B1 and B6

@@ Line 9: / Line 9: @@
 == Neuralgias ==
-Trigeminal neuralgia
+*'''Trigeminal neuralgia'''
 sharp stabbing episodic electric shock like pain; lasts a few sec
 trigger zone - stimulated by washin face/shaving etc.
-treat by carbamazepine 100mg 2x day - LA injected to trigger zone can relief pain 					temporarily
-Glossopharyngeal neuralgia
+Treated with carbamazepine 100mg 2x per day.
+Local anesthetic, injected to trigger zone can relief pain temporarily
-posterolateral tongue + ear of affected side; stimuli -> eating, drinking, speaking
+*'''Glossopharyngeal neuralgia'''
+Posterolateral tongue + ear of affected side; stimuli -> eating, drinking, speaking
+*'''Preherpetic neuralgia'''
+Aching, burning pain, limited to distribution of trigeminal nerve
+Treated with high dose acyclovir
+*'''Postherpetic neuralgia'''
-Preherpetic neuralgia -
+Unpleasant burning pain.
-aching, burning pain, limited to distribution of CN 5, high dose acyclovir
-Postherpetic neuralgia -
+Blockade of stellate ganglion with bupivicaine (local anesthetic) (short term relief)
-unpleasant burning pain, LA blockade of stellate ggl with bupivicaine (short term relief)
 ==  Pain of vascular origin ==
-migraine - intense persisting aching pain, unilateral; stimuli -> food, alcohol, stress, hormones, give painkillers
+*'''migraine'''
+Intense persisting aching pain, unilateral; stimuli -> food, alcohol, stress, hormones, give painkillers
+*'''cluster headache'''
+Intense aching pain that disturbs sleep, nasal congestion.
+Stimuli : alcohol, vasodilators, high altitude.
+Treat with ergotamine or sumatriptan.
-cluster headache - intense aching pain that disturbs sleep, nasal congestion;
+*'''Giant cell arteritis'''
-stimuli -> alcohol, vasodilators, high altitude - treat with ergotamine or sumatriptan
-giant cell arteritis - throbbing headache, unilateral, fever, malaise, weight loss, high dose prednisolone to treat
+Throbbing headache, unilateral, fever, malaise, weight loss,  treated with high dose prednisolone.
 ==  Atypical orofacial pain ==
-gripping, vice like aching pain, feeling of pressure
+Gripping, vice like aching pain, feeling of pressure
 ==  Burning mouth syndrome ==
-*type 1 (not present on waking);
+*type 1 (not present on waking)
-*type 2 (present on waking);
+*type 2 (present on waking)
-*type 3 - intermittent -> Possible deficiency of vitamin B1 and B6
+*type 3 - intermittent - Possible deficiency of vitamin B1 and B6