Benoliel Rafael, Sharav Yair, Heiliczer Shimrit, Haviv Yaron
Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ 07103, USA.
Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel.
Biomedicines. 2025 Mar 14;13(3):714. doi: 10.3390/biomedicines13030714.
The International Classification of Orofacial Pain (ICOP) recognizes orofacial migraine (OFM) and neurovascular orofacial pain (NVOP) as migraine-related entities affecting the facial and oral regions. The diagnostic features of OFM and NVOP indicate that there are many similarities between the two. However, we recently demonstrated that NVOP and OFM are two distinct diagnostic entities, confirming the ICOP classification. It was the aim of the present study to examine whether OFM and NVOP differ in response to pharmacotherapy. : The cohort was made up of 40 patients attending a tertiary orofacial pain clinic. When implementing ICOP criteria, an OFM diagnosis was made in 23 and an NVOP diagnosis in 17. : No statistically significant differences between NVOP versus OFM were observed in the global response to standard abortive therapy such as triptans, or NSAIDs. Similarly, no statistically significant differences were found following prophylactic therapy that included beta-blockers, anti-epileptic drugs, and tricyclic antidepressants. Up to 80% of patients responded favorably with ≥50% pain reduction. : NVOP and OFM differ in diagnostic characteristics, demonstrating unique features, and were confirmed as two diagnostic entities. However, NVOP and OFM did not differ in their response to abortive or prophylactic treatments. Study limitations include the lack of starting data precluding a more precise pharmacological analysis. The small sample size limits any far reaching conclusions. This is particularly true regarding individual drug efficacy. We were unable to analyze drug and dose responses separately due to data constraints.
国际口面部疼痛分类（ICOP）将口面部偏头痛（OFM）和神经血管性口面部疼痛（NVOP）视为影响面部和口腔区域的与偏头痛相关的病症。OFM和NVOP的诊断特征表明两者之间存在许多相似之处。然而，我们最近证明NVOP和OFM是两个不同的诊断实体，这证实了ICOP分类。本研究的目的是检验OFM和NVOP在药物治疗反应方面是否存在差异。该队列由40名就诊于三级口面部疼痛诊所的患者组成。按照ICOP标准进行诊断时，23例被诊断为OFM，17例被诊断为NVOP。在对曲坦类药物或非甾体抗炎药等标准的终止性治疗的总体反应中，未观察到NVOP与OFM之间存在统计学上的显著差异。同样，在包括β受体阻滞剂、抗癫痫药物和三环类抗抑郁药在内的预防性治疗后，也未发现统计学上的显著差异。高达80%的患者有良好反应，疼痛减轻≥50%。NVOP和OFM在诊断特征上存在差异，具有独特的特点，并被确认为两个诊断实体。然而，NVOP和OFM在对终止性或预防性治疗的反应方面没有差异。研究的局限性包括缺乏起始数据，无法进行更精确的药理学分析。样本量小限制了得出任何深远的结论。在个体药物疗效方面尤其如此。由于数据限制，我们无法分别分析药物和剂量反应。
