Giri Subha, Nixdorf Donald
Minnesota Head and Neck Pain Clinic, Minneapolis, MN, USA.
J Can Dent Assoc. 2007 Mar;73(2):163-7.
Complex regional pain syndrome (CRPS) is a chronic condition characterized by intense pain, swelling, redness, hypersensitivity and additional sudomotor effects. In all 13 cases of CRPS in the head and neck region reported in the literature, nerve injury was identified as the etiology for pain initiation. In this article, we present the case of a 30-year-old female patient with sympathetically maintained pain without apparent nerve injury. Her main symptoms--left-side preauricular pain and inability to open her mouth wide--mimicked temporomandibular joint arthralgia and myofascial pain of the masticatory muscles. Later, symptoms of intermittent preauricular pain and swelling developed, along with hyposalivation, which mimicked parotitis. After an extensive diagnostic process, no definitive underlying pathology could be identified and a diagnosis of neuropathic pain with a prominent sympathetic component was made. Two years after the onset of symptoms and initiation of care, treatment with repeated stellate ganglion blocks and enteral clonidine pharmacotherapy provided adequate pain relief.
复杂性区域疼痛综合征（CRPS）是一种慢性疾病，其特征为剧烈疼痛、肿胀、发红、超敏反应以及其他汗腺运动效应。在文献报道的所有13例头颈部CRPS病例中，神经损伤被确定为疼痛起始的病因。在本文中，我们介绍了一名30岁女性患者的病例，该患者存在交感神经维持性疼痛，但无明显神经损伤。她的主要症状——左耳前疼痛和无法张大嘴巴——类似于颞下颌关节痛和咀嚼肌肌筋膜疼痛。后来，出现了间歇性耳前疼痛和肿胀的症状，同时伴有唾液分泌减少，类似于腮腺炎。经过广泛的诊断过程，未发现明确的潜在病理，因此诊断为具有显著交感神经成分的神经性疼痛。症状出现并开始治疗两年后，反复进行星状神经节阻滞和口服可乐定药物治疗提供了充分的疼痛缓解。
