Trigeminal neuralgic-type pain and vascular-type headache due to gustatory stimulus.
We present a case of facial pain associated with sweet stimulus. An immediate, electric-like, short, unilateral pain was evoked by strong sweet gustatory stimulation. This was followed 6 to 8 hours later by a bilateral severe headache associated with bilateral tearing, rhinorrhea, periorbital swelling, flushing, and photophobia that lasted up to 2 days. The immediate pain that was experimentally induced with 2.5 grams of sucrose placed on the tongue could be abolished with carbamazepine. However, carbamazepine did not prevent the headache complex that appeared 6 to 8 hours later. Conversely, a trial with indomethacin abolished the late-onset headache, but not the immediate neuralgic-type pain. The independent nature of these pains suggests different pathophysiological mechanisms which are discussed.
Helcer
M
M
Department of Oral Diagnosis, Oral Medicine and Oral Radiology, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.
Schnarch
A
A
Benoliel
R
R
Sharav
Y
Y
D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002220:Carbamazepine; D019422:Dietary Sucrose / Q000009:adverse effects; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D008875:Middle Aged; D013549:Sweetening Agents / Q000009:adverse effects*; D014277:Trigeminal Neuralgia / Q000139:chemically induced* / Q000188:drug therapy; D014653:Vascular Headaches / Q000175:diagnosis* / Q000188:drug therapy
D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019422:Dietary Sucrose; D013549:Sweetening Agents; D002220:Carbamazepine; D007213:Indomethacin