Cranial and Facial Pain Disorders

Persistent discomfort

Caused by dysfunction of TMJ, muscles, ligaments

TMJ noise and pain, limited jaw movement, locking of the jaw on opening, bruxism, tongue+lip+cheek biting

Acute and associated with jaw movement

Multidisciplinary team for treatment

Simple radiographs are of little use

Dx required sophisticated imaging

Simple analgesics or NSAIDs as initial Rx

Paroxysms of severe unilateral pain

Seconds duration

Normal neurological finding

No pain between paroxysm

Carbamazepine is effective

If fail --> unlikely to be trigeminal neuralgia

If retractable --> consult or refer to neurologist or neurosergeon

Summarized By Thirayost Nimmanon

โดย ธีรยสถ์ นิมมานนท์

ปรับปรุงครั้งล่าสุด 15/06/2010