Cracked tooth syndrome mimicking trigeminal autonomic cephalalgia: A report of four cases
Cracked tooth syndrome mimicking trigeminal autonomic cephalalgia: A report of four cases
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DOI：
10.3290/j.qi.a37688
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发表时间：
2017-04-01
影响因子：
1.9
通讯作者：
Khan, Junad
中科院分区：
文献类型：
--
作者：
Noma, Noboru;Shimizu, Kohei;Khan, Junad
背景资料：本报告描述了四例继发于创伤性咬合的裂齿综合征，模仿三叉神经自主性头痛。所有患者均由全科医生转诊至日本大学牙科学院口面部疼痛诊所进行非典型面部疼痛评估。临床表现：病例1：一位51岁的女性，因上颌和下颌左磨牙严重疼痛而就诊。病例2：一位47岁女性，因上颌左臼齿处放射至太阳穴和眶周区域的尖锐刺痛而就诊。病例3：一位49岁男性，因上颌左臼齿尖锐、刺痛而就诊。案例四：一位38岁男性因左侧眶上、眶下区剧烈的面部疼痛而就诊，疼痛向颞顶和上颌区放射。所有病例均模仿三叉神经自主性头痛，这是一组原发性头痛疾病，其特征为单侧面部疼痛和同侧颅自主神经症状。三叉神经自主性头痛包括丛集性头痛、阵发性偏头痛、持续性偏头痛以及伴有结膜注射和流泪的持续性单侧神经痛状头痛发作/具有颅自主神经特征的持续性神经痛状头痛发作。牙髓坏死，当由裂牙综合征引起时，可以表现为疼痛频率和持续时间，这在牙髓炎中是不寻常的，正如在这些病例中所看到的那样。结论：虽然具有挑战性，但鉴别牙隐裂综合征和三叉神经自主神经性头痛是牙科医生的必要技能。
Background: This report describes four cases of cracked tooth syndrome secondary to traumatic occlusion that mimicked trigeminal autonomic cephalalgias. All patients were referred by general practitioners to the Orofacial Pain Clinic at Nihon University Dental School for assessment of atypical facial pain. Clinical Presentation: Case 1: A 51-year-old woman presented with severe pain in the maxillary and mandibular left molars. Case 2: A 47-year-old woman presented with sharp, shooting pain in the maxillary left molars, which radiated to the temple and periorbital region. Case 3: A 49-year-old man presented with sharp, shooting, and stabbing pain in the maxillary left molars. Case 4: A 38-year-old man presented with intense facial pain in the left supraorbital and infraorbital areas, which radiated to the temporoparietal and maxillary regions. All cases mimicked trigeminal autonomic cephalalgias, a group of primary headache disorders characterized by unilateral facial pain and ipsilateral cranial autonomic symptoms. Trigeminal autonomic cephalalgias include cluster headache, paroxysmal hemicrania, hemicrania continua, and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing/short-lasting neuralgiform headache attacks with cranial autonomic features. Pulpal necrosis, when caused by cracked tooth syndrome, can manifest with pain frequencies and durations that are unusual for pulpitis, as was seen in these cases. Conclusion: Although challenging, differentiation of cracked tooth syndrome from trigeminal autonomic cephalalgias is a necessary skill for dentists.