Orofacial trigeminal autonomic cephalalgias: A review of case reports.

IF 1.9 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Cranio-The Journal of Craniomandibular & Sleep Practice Pub Date : 2025-07-31 DOI:10.1080/08869634.2025.2541123

Jack Botros, Donald R Nixdorf

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引用次数: 0

Abstract

Objective: To describe the characteristics of trigeminal autonomic cephalalgias (TAC) presenting as orofacial pain.

Methods: A web search was performed on various databases to find relevant case reports or series reporting TAC presenting in V2 and/or V3 of the trigeminal ‎nerve distribution. Headaches were classified according to the International Classification of Headache Disorders III and the International Classification of Orofacial Pain. Descriptive analyses were employed, and multivariable linear regression models assessed the factors associated with (i) longer time since the onset of TAC and (ii) a higher number of previous providers‎ at the time of report.

Results: Intraoral/tooth pain was reported by 47% (n = 34) of cases, with 11 without headache or V1 involvement. Cases had an average of 2.2 autonomic symptoms ‎‎(standard deviation (SD) = 1.3), 4.5 years since onset (SD = 5.3), and 2.6 previous ‎providers (SD = 1.5) at the time of the report. Autonomic symptoms increased as the time since pain onset (n = 50, β = 1.30, p = .026) and age (β = 0.13, p = .032) ‎increased when adjusted for sex and the trigeminal distribution of involvement. The number of previous providers tended to be lower for TAC with shorter episodes (β = -1.48, SD = 0.47, p = .004) than for TAC with long attacks or continuous pain.

Conclusion: Orofacial TAC present a diagnostic challenge for clinicians. Multidisciplinary care and more education are recommended. Further research is needed to properly understand them.

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口面三叉神经自主神经性头痛：病例报告回顾。

目的：探讨以口面部疼痛为表现的三叉神经自主神经性头痛（TAC）的特点。方法：在各种数据库中进行网络检索，以查找出现在三叉神经V2和/或V3分布的相关病例报告或系列报告TAC。根据国际头痛疾病分类III和国际口面部疼痛分类对头痛进行分类。采用描述性分析，多变量线性回归模型评估了与以下因素相关的因素：(i) TAC发病时间较长，（ii）报告时以前的提供者数量较多。结果：47% （n = 34）的病例报告口腔内/牙齿疼痛，其中11例没有头痛或V1受累。病例平均有2.2例自主神经症状（标准差(SD) = 1.3），发病4.5年（SD = 5.3），报告时有2.6例既往供体（SD = 1.5）。经性别和三叉神经受累分布调整后，自主神经症状随疼痛发作时间（n = 50, β = 1.30, p = 0.026）和年龄（β = 0.13, p = 0.032）的增加而增加。对于发作时间较短的TAC (β = -1.48, SD = 0.47, p = 0.004)，以前的供方数量往往低于发作时间较长或持续疼痛的TAC。结论：口腔面部TAC对临床医生提出了诊断挑战。建议多学科治疗和更多的教育。需要进一步的研究来正确地理解它们。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cranio-The Journal of Craniomandibular & Sleep Practice DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

4.50

自引率

12.50%

发文量

审稿时长

>12 weeks

期刊介绍： CRANIO: The Journal of Craniomandibular & Sleep Practice is the oldest and largest journal in the world devoted to temporomandibular disorders, and now also includes articles on all aspects of sleep medicine. The Journal is multidisciplinary in its scope, with editorial board members from all areas of medicine and dentistry, including general dentists, oral surgeons, orthopaedists, radiologists, chiropractors, professors and behavioural scientists, physical therapists, acupuncturists, osteopathic and ear, nose and throat physicians. CRANIO publishes commendable works from outstanding researchers and clinicians in their respective fields. The multidisciplinary format allows individuals practicing with a TMD emphasis to stay abreast of related disciplines, as each issue presents multiple topics from overlapping areas of interest. CRANIO''s current readership (thousands) is comprised primarily of dentists; however, many physicians, physical therapists, chiropractors, osteopathic physicians and other related specialists subscribe and contribute to the Journal.