[Determining the diagnosis from the pain pattern. Brief and stabbing or chronic and dull?].
For the neurological differential diagnosis of facial pain, symptomatic pain must be differentiated from the so-called primary pain syndromes. Trigeminal neuralgia is usually readily diagnosed on the basis of the typical history. The treatment of choice is carbamazepine. If this fails, invasive options are available. Atypical facial pain should be diagnosed only when all known primary and secondary pain syndromes have been excluded. Treatment is difficult and comprises the administration of tricyclic antidepressants. Cluster headache and chronic paroxysmal hemicrania each has an unmistakable temporal course. Although the etiology remains unknown, specific therapeutic options are available. The Tolosa-Hunt syndrome is presumably caused by a granuloma in the cavernous sinus, and treatment is effected with corticosteroids. Painful craniomandibular dysfunction (CMD) is often misinterpreted as atypical facial pain.
Sommer
C
C
Neurologische Universitätsklinik Würzburg. sommer@mail.uni-wuerzburg.de
D003027:Cluster Headache / Q000175:diagnosis*; D003389:Cranial Nerve Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005156:Facial Neuralgia / Q000145:classification / Q000209:etiology*; D006801:Humans; D010147:Pain Measurement; D014277:Trigeminal Neuralgia / Q000175:diagnosis*; D014653:Vascular Headaches / Q000175:diagnosis*