• J Oral Facial Pain Headache · Jan 2020

    Features of Neurovascular Orofacial Pain Compared to Painful Posttraumatic Trigeminal Neuropathy.

    • Yaron Haviv, Avraham Zini, Naama Keshet, Galit Almoznino, Rafael Benoliel, and Yair Sharav.
    • J Oral Facial Pain Headache. 2020 Jan 1; 34 (2): 121–128.

    AimsTo test and re-examine the diagnostic criteria for neurovascular orofacial pain (NVOP) compared to posttraumatic trigeminal neuropathy (PTTN).MethodsPain and patient characteristics were compared in patients with NVOP, PTTN, and NVOP initiated by trauma (PT-NVOP). NVOP criteria were based on prior studies, and PTTN was defined according to the International Classification of Headache Disorders, version 3 beta.ResultsOf the 170 patients in the cohort, 90 had PTTN, 51 had NVOP, and 29 had PT-NVOP. None of the tested parameters in the NVOP and PT-NVOP patients were significantly different, and therefore these patients were combined into one group (T-NVOP). T-NVOP differed significantly from PTTN (P < .001) in periodic pain patterns, presence of autonomic and systemic signs, throbbing pain quality, and frequency of bilaterality. Pain quality in PTTN was more burning/stabbing than in NVOP (P = .003). Pain severity, waking from sleep, muscle sensitivity to palpation, and demographics were comparable.ConclusionNVOP differs from PTTN in parameters essential to diagnosis: periodicity of pain, presence of autonomic and systemic accompanying signs, throbbing pain quality, and bilateral presentation. NVOP is amenable to abortive and prophylactic antimigraine therapies, distinguishing NVOP from PTTN in clinical features, treatment, and prognosis.

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