[62-year-old patient with chronic pain in the area of the carotid arteries].
A 62-year-old woman was admitted for investigation of severe chronic recurring lateral neck pain radiating to the face with predilection for the right side for 30 years. The main clinical finding was tenderness of the extracranial carotid arteries (Fay's sign). The ultrasound-investigation of the neck- and brain-arteries did not reveal any pathological findings. The laboratory investigations provided no evidence of inflammation but revealed primary hyperparathyreoidism. Lateral radiating neck pain with tenderness of the carotid arteries are summarized under the term carotidynia, provided no pathological changes of the arteries are found. Whether carotidynia actually is an entity is uncertain. Nevertheless it is suggested to maintain the term for a carotid pain-syndrome whenever dangerous pathological conditions of the carotid arteries have been ruled out. In acute varieties which normally respond to NSAID a infectious aetiology has been postulated. Chronic carotidynias are probably a variety of migraine and tend to resolve with an antimigraineous therapy. There do not exist any reports on the coincidence of carotidynia and hyperparathyreoidism. After an attempt for parathyreoidectomy which failed because of extensive local scaring the patient was persistently free of pain without any obvious pathophysiological explanation for this fact.
Wermelinger
F
F
Abteilung für Nephrologie, Inselspital, Bern.
Frey
F J
FJ
D000236:Adenoma / Q000175:diagnosis / Q000601:surgery; D002339:Carotid Arteries; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology*; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery; D016105:Parathyroidectomy; D013965:Thyroidectomy