J Orofac Pain
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To compare prevalences of self-reported temporomandibular joint and muscle disorders (TMJMD)-type pain in the 2002 U.S. National Health Interview Survey (NHIS) by age and gender for non-Hispanic whites (Caucasians) and non-Hispanic blacks (African Americans). ⋯ This is the first report of findings from a nationally representative US sample for TMJMD-type pain by age and race/ethnicity. TMJMD-type pain differed significantly by race, age, and gender after adjusting for socioeconomic status.
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To investigate the relative importance of systemic and local inflammatory mediators (serotonin: 5-HT; tumor necrosis factor: TNF; soluble interleukin-1 receptor II: IL-1sRII) in the modulation of temporomandibular joint (TMJ) pressure pain threshold in patients with seropositive or seronegative rheumatoid arthritis (RA) and to investigate to what extent TMJ pressure pain threshold is related to other TMJ pain parameters. ⋯ The results indicate that TMJ pressure pain threshold is modulated by systemic rather than local inflammatory mediators and suggest that it is unrelated or only weakly related to other TMJ pain entities in RA patients. A rheumatoid factor-dependent systemic modulation, in combination with local factors, seems to account for TMJ pain in RA patients.
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Nasopharyngeal cancer can occur in any age group and is often misdiagnosed. Cervicogenic headache (CEH) is a clinical condition, putatively originating from nociceptive structures in the neck. A patient with CEH-like symptoms occurring as a result of nasopharyngeal cancer invasion is reported. ⋯ Cervical computerized tomography revealed a solid tumor in the right parapharyngeal region, adjacent to the C2-C3 vertebrae. To the authors' knowledge, this is the first case in the literature of tumoral invasion of nasopharyngeal cancer presenting as CEH. Cervical neuroimaging is obligatory in patients with late-onset, severe CEH.
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To compare the tactile detection threshold, the filament-prick pain detection threshold, the pressure pain threshold, and the pressure pain tolerance detection threshold at multiple measuring points in the orofacial region and at the thenar muscle of symptom-free subjects and patients with myofascial pain of the masticatory muscles. ⋯ The findings of the present study show topographic variations in the pain responses to different stimulus modalities. Different pain responses were also found between patients with myofascial pain and control subjects and were interpreted to support theories of centrally mediated pain for temporomandibular disorders.
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To describe 1 year's experience in treating orofacial pain with intramuscular injections of 0.5% bupivacaine bilateral to the spinous processes of the lower cervical vertebrae. ⋯ This is the first report of a large case series of emergency department patients whose orofacial pain conditions were treated with intramuscular injections of bupivacaine in the paraspinous muscles of the lower neck. The findings suggest that lower cervical paraspinous intramuscular injections with bupivacaine may prove to be a new therapeutic option for acute orofacial pain in the emergency department setting.