Pertes R A
Department of Oral Pathology, Oral Biology, and Diagnostic Sciences, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark 07103-2400, USA.
Mt Sinai J Med. 1998 Oct-Nov;65(5-6):348-54.
Orofacial pain, especially if the problem is chronic, presents a diagnostic and management challenge to all health practitioners. This paper suggests how clinicians might simplify the diagnosis of orofacial pain. First, the pain is classified into one of the three basic pain categories: somatic, neuropathic, or psychogenic pain. Somatic pain results from noxious stimulation of normal neural structures. Neuropathic pain is caused by a structural abnormality in the nervous system. Psychogenic pain arises from psychic causes; there is no apparent physiologic or organic basis for the pain. The next step is to determine the tissue system from which the pain arises: intracranial, extracranial, musculoskeletal, neurovascular, neurogenous, or psychological. Finally, some of the more common orofacial pain syndromes within each category are discussed.
口面部疼痛，尤其是当问题为慢性时，对所有医疗从业者而言都是一项诊断和管理方面的挑战。本文提出了临床医生可如何简化口面部疼痛的诊断方法。首先，将疼痛归类为三种基本疼痛类型之一：躯体性疼痛、神经性疼痛或精神性疼痛。躯体性疼痛源于对正常神经结构的有害刺激。神经性疼痛由神经系统的结构异常引起。精神性疼痛源自心理原因；疼痛没有明显的生理或器质性基础。下一步是确定疼痛产生的组织系统：颅内、颅外、肌肉骨骼、神经血管、神经源性或心理性。最后，讨论了每一类中一些较常见的口面部疼痛综合征。
