Pfaffenrath V, Rath M, Keeser W, Pöllmann W
Neurologische Praxis, München.
Nervenarzt. 1992 Oct;63(10):595-601.
Atypical facial pain is generally an unclearly defined pain syndrome. We tested in 35 patients (31 women, 4 men) with a mean age of 53.2 +/- 14.9 years and a chronic facial pain syndrome the quality of the new diagnostic criteria of the International Headache Society (IHS), at the same time using the SCL-90-R (Self-Report Symptom Inventory), to identify any associated psychopathology. In accordance with the literature there is a marked female preponderance, an altogether vague description of symptoms and a long history of incorrect diagnoses. Of note is the high number of invasive procedures (3.5 +/- 3.0). In agreement with the IHS commentary, an operation or injury to the face was a suspected cause in 43%. In contrast to the IHS criteria, we found in our patient sample dysaesthesia (63%), bilateral occurrence (37%), remission periods (57%), pain attacks (23%) and presence of superficial as well as deep pain. Depression is by no means the only psychopathological abnormality in atypical facial pain; a broad spectrum of complaints is seen. The IHS classification appears insufficient to separate atypical facial pain from other primary headache and facial pain syndromes. We therefore suggest a modified version of the IHS criteria for atypical facial pain.
非典型面部疼痛通常是一种定义不明确的疼痛综合征。我们对35例患者(31名女性,4名男性)进行了测试,这些患者平均年龄为53.2±14.9岁,患有慢性面部疼痛综合征,同时使用症状自评量表(SCL - 90 - R)来确定是否存在任何相关的精神病理学问题,以此检验国际头痛协会(IHS)新诊断标准的适用性。根据文献记载,该病明显以女性居多,症状描述总体模糊,且误诊历史较长。值得注意的是,侵入性检查的次数较多(3.5±3.0次)。与IHS评论一致的是,43%的患者怀疑面部手术或受伤是病因。与IHS标准不同的是,我们在患者样本中发现了感觉异常(63%)、双侧发病(37%)、缓解期(57%)、疼痛发作(23%)以及浅表和深部疼痛。抑郁症绝不是非典型面部疼痛中唯一的精神病理异常;还可见到广泛的症状。IHS分类似乎不足以将非典型面部疼痛与其他原发性头痛和面部疼痛综合征区分开来。因此,我们建议对IHS非典型面部疼痛标准进行修订。