Sarlani Eleni, Balciunas Birute A, Grace Edward G
Department of Diagnostic Sciences and Pathology, Brotman Facial Pain Center, Dental School, University of Maryland, Baltimore 21201-1586, USA.
AACN Clin Issues. 2005 Jul-Sep;16(3):333-46. doi: 10.1097/00044067-200507000-00007.
Orofacial pain is a common complaint, affecting the lives of millions of people around the world. Chronic orofacial pain often constitutes a challenging diagnostic problem that can be complicated by psychosocial factors and typically requires multidisciplinary treatment approaches. The fundamental prerequisite for successful management of orofacial pain is an accurate diagnosis. Generating a differential diagnosis, which will ultimately lead to a definite diagnosis, requires thorough knowledge of the diagnostic range of orofacial pain. There is a vast array of orofacial pain categories including: (1) musculoskeletal, (2) neuropathic, (3) vascular, (4) neurovascular, (5) idiopathic, (6) pain caused by local, distant, or systemic pathology, and (7) psychogenic. This article presents the salient clinical features and the therapeutic approaches for the various subtypes of musculoskeletal and neuropathic pain. Musculoskeletal pain is the most prevalent orofacial pain, with temporomandibular disorders and tension-type headache being the main examples. Neuropathic pain develops secondary to neural injury and/or irritation and can be distinguished into episodic, including trigeminal neuralgia and glossopharyngeal neuralgia, as well as continuous, such as herpetic and postherpetic neuralgia, traumatic neuralgia, and Eagle's syndrome.
口面部疼痛是一种常见的主诉，影响着全球数百万人的生活。慢性口面部疼痛往往构成一个具有挑战性的诊断问题，可能因社会心理因素而变得复杂，通常需要多学科的治疗方法。成功管理口面部疼痛的基本前提是准确的诊断。要得出最终能明确诊断的鉴别诊断，需要对口面部疼痛的诊断范围有透彻的了解。口面部疼痛类别繁多，包括：(1) 肌肉骨骼性的，(2) 神经性的，(3) 血管性的，(4) 神经血管性的，(5) 特发性的，(6) 由局部、远处或全身病变引起的疼痛，以及(7) 心因性的。本文介绍了肌肉骨骼性和神经性疼痛各亚型的显著临床特征及治疗方法。肌肉骨骼性疼痛是最常见的口面部疼痛，颞下颌关节紊乱症和紧张型头痛是主要例子。神经性疼痛继发于神经损伤和/或刺激，可分为发作性的，包括三叉神经痛和舌咽神经痛，以及持续性的，如疱疹性和疱疹后神经痛、创伤性神经痛和鹰综合征。
