Wermelinger F, Frey F J
Abteilung für Nephrologie, Inselspital, Bern.
Praxis (Bern 1994). 1998 Mar 18;87(12):423-6.
A 62-year-old woman was admitted for investigation of severe chronic recurring lateral neck pain radiating to the face with predilection for the right side for 30 years. The main clinical finding was tenderness of the extracranial carotid arteries (Fay's sign). The ultrasound-investigation of the neck- and brain-arteries did not reveal any pathological findings. The laboratory investigations provided no evidence of inflammation but revealed primary hyperparathyreoidism. Lateral radiating neck pain with tenderness of the carotid arteries are summarized under the term carotidynia, provided no pathological changes of the arteries are found. Whether carotidynia actually is an entity is uncertain. Nevertheless it is suggested to maintain the term for a carotid pain-syndrome whenever dangerous pathological conditions of the carotid arteries have been ruled out. In acute varieties which normally respond to NSAID a infectious aetiology has been postulated. Chronic carotidynias are probably a variety of migraine and tend to resolve with an antimigraineous therapy. There do not exist any reports on the coincidence of carotidynia and hyperparathyreoidism. After an attempt for parathyreoidectomy which failed because of extensive local scaring the patient was persistently free of pain without any obvious pathophysiological explanation for this fact.
一名62岁女性因严重慢性复发性颈部外侧疼痛伴面部放射痛（右侧为主）30年入院接受检查。主要临床发现是颅外颈动脉压痛（费氏征）。颈部和脑部动脉的超声检查未发现任何病理结果。实验室检查未发现炎症证据，但显示原发性甲状旁腺功能亢进。颈部外侧放射痛伴颈动脉压痛在未发现动脉病理改变的情况下被归纳为颈动脉痛。颈动脉痛是否真的是一种独立疾病尚不确定。然而，每当排除了颈动脉的危险病理状况时，建议保留该术语来描述颈动脉疼痛综合征。在通常对非甾体抗炎药有反应的急性类型中，推测有感染性病因。慢性颈动脉痛可能是偏头痛的一种类型，倾向于通过抗偏头痛治疗得到缓解。目前尚无关于颈动脉痛与甲状旁腺功能亢进并存的报道。在因广泛局部瘢痕形成导致甲状旁腺切除术尝试失败后，患者持续无痛，对此事实尚无明显的病理生理学解释。
