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以孤立性面部痛为表现的偏头痛:58 例前瞻性临床分析。

Migraine presenting as isolated facial pain: A prospective clinical analysis of 58 cases.

机构信息

The Headache Service, Pain Management and Neuromodulation Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Orofacial Pain Service, Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, UK.

出版信息

Cephalalgia. 2020 Oct;40(11):1250-1254. doi: 10.1177/0333102420933277. Epub 2020 Jun 17.

Abstract

BACKGROUND

Sparse evidence has detailed the clinical phenotype of migraine presenting as isolated facial pain. This was a prospective audit, part of our multidisciplinary facial pain service evaluation, aiming to phenotype patients with migraine presenting as isolated facial pain who attended our service between 2013 and 2018.

RESULTS

Fifty-eight patients were diagnosed with migraine with isolated facial pain (F = 46, 79.3%; mean age: 49.0 years, ± 9.85). Sixty-six percent of patients met the criteria for episodic migraine. The pain was strictly unilateral in 79% and located over the maxillary region in 85% of patients. Associated cranial autonomic signs/symptoms were reported by 45% of our cohort. A percentage of 77% of patients was triptan responders.

CONCLUSIONS

Migraine presenting as isolated facial pain is a rare but treatable condition with some distinct demographic and clinical characteristics. It is a diagnosis of exclusion that should be evaluated in specialised multidisciplinary facial pain clinics.

摘要

背景

关于以孤立性面部疼痛为表现的偏头痛的临床表型,仅有少量证据作详细描述。这是前瞻性审计的一部分,是我们多学科面部疼痛服务评估的一部分,目的是对 2013 年至 2018 年期间在我们服务中就诊的以孤立性面部疼痛为表现的偏头痛患者进行表型分析。

结果

58 例患者被诊断为偏头痛伴孤立性面部疼痛(F=46,79.3%;平均年龄:49.0 岁,±9.85)。66%的患者符合发作性偏头痛的标准。79%的患者疼痛严格单侧,85%的患者疼痛位于上颌区域。我们队列中有 45%的患者报告存在颅自主神经症状/体征。77%的患者对曲普坦类药物有反应。

结论

以孤立性面部疼痛为表现的偏头痛是一种罕见但可治疗的疾病,具有一些独特的人口统计学和临床特征。这是一种排除性诊断,应在专门的多学科面部疼痛诊所进行评估。

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