RESUMO
PURPOSE OF REVIEW: Trigeminal neuralgia (TN) and trigeminal autonomic cephalalgias (TACs) are both painful diseases which directly impact the branches of the trigeminal nerve, which supply the face. Patients who have experienced adverse effects, have not responded to mainstream treatments, or have a personal preference for nonmedication options, often turn to complementary and integrative medicine (CIM). The aim of this review is to discuss the efficacy and safety of CIM therapies available for the treatment of TN and TACs. RECENT FINDINGS: Not only are there limited therapeutic options for TN and TAC patients, but also is there a proportion of patients who are intolerant to standard medical treatments. Recent findings have illustrated that 86% of patients with headache disorders utilize CIM modalities in combination with mainstream medical therapy. CIM modalities can be helpful for these diseases and have primarily been studied in combination with standard medical therapy. There is limited evidence for CIM and behavioral therapies in managing these conditions, and more research is needed to confirm which therapies are safe and effective.
Assuntos
Transtornos da Cefaleia , Medicina Integrativa , Cefalalgias Autonômicas do Trigêmeo , Neuralgia do Trigêmeo , Humanos , Neuralgia do Trigêmeo/terapia , Cefalalgias Autonômicas do Trigêmeo/tratamento farmacológico , Nervo TrigêmeoRESUMO
PURPOSE OF REVIEW: There is increasing interest in the use of cannabis and cannabinoid therapies (CCT) by the general population and among people with headache disorders, which results in a need for healthcare professionals to be well versed with the efficacy and safety data. In this manuscript, we review cannabis and cannabinoid terminology, the endocannabinoid system and its role in the central nervous system (CNS), the data on efficacy, safety, tolerability, and potential pitfalls associated with use in people with migraine and headache disorders. We also propose possible mechanisms of action in headache disorders and debunk commonly held myths about its use. RECENT FINDINGS: Preliminary studies show that CCT have evidence for the management of migraine. While this evidence exists, further randomized, controlled studies are needed to better support its clinical use. CCT can be considered an integrative treatment added to mainstream medicine for people with migraine who are refractory to treatment and/or exhibit disability and/or interest in trying these therapies. Further studies are warranted to specify appropriate formulation, dosage, and indication(s). Although not included in guidelines or the AHS 2021 Consensus Statement on migraine therapies, with the legalization of CCT for medical or unrestricted use across the USA, recent systematic reviews highlighting the preliminary evidence for its use in migraine, it is vital for clinicians to be well versed in the efficacy, safety, and clinical considerations for their use. This review provides information which can help people with migraine and clinicians who care for them make mutual, well-informed decisions on the use of cannabis and cannabinoid therapies for migraine based on the existing data.
Assuntos
Canabinoides , Cannabis , Maconha Medicinal , Transtornos de Enxaqueca , Humanos , Canabinoides/uso terapêutico , Midazolam/uso terapêutico , Maconha Medicinal/uso terapêutico , Transtornos de Enxaqueca/tratamento farmacológico , Agonistas de Receptores de CanabinoidesRESUMO
To evaluate the effect of cigarette smoking (CS) on pain intensity in a sample of temporomandibular disorder (TMD) patients, 352 clinical charts were reviewed. Subjects were first divided into two groups: smokers (YS) and nonsmokers (NS); then, YS were further divided into three subgroups: light smokers (LS), moderate smokers (MS), and heavy smokers (HS). Overall TMD pain intensity was higher in YS, compared to NS, and a correlation was found between pain intensity and the number of cigarettes smoked in a day by each subject. A significant difference was evident between NS and HS. The results were not evident in males; age was not correlated either with smoking or pain intensity, and the effect of CS on pain intensity was not correlated with any particular TMD diagnosis. CS seems to be a relevant factor affecting the intensity of TMD pain, thus, control of smoking habits should be considered when treating TMD patients.
Assuntos
Medição da Dor , Fumar/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Adulto , Artralgia/fisiopatologia , Dor Facial/fisiopatologia , Feminino , Humanos , Luxações Articulares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Osteoartrite/fisiopatologia , Projetos Piloto , Estudos Retrospectivos , Fatores Sexuais , Disco da Articulação Temporomandibular/patologia , Síndrome da Disfunção da Articulação Temporomandibular/fisiopatologia , Adulto JovemRESUMO
Smoking is a prevalent behavior with severe health consequences. Various smoking cessation methods that are available to dentists include nicotine replacement therapies, other pharmacological agents, and biobehavioral therapies. This article presents a smoking cessation protocol that can be carried out as part of routine oral care.
Assuntos
Assistência Odontológica , Educação de Pacientes como Assunto , Abandono do Hábito de Fumar/métodos , Protocolos Clínicos , Aconselhamento , Árvores de Decisões , Humanos , Padrões de Prática OdontológicaAssuntos
Neoplasias Cerebelares/diagnóstico , Ângulo Cerebelopontino , Dor Facial/etiologia , Meningioma/diagnóstico , Neuralgia do Trigêmeo/etiologia , Neoplasias Cerebelares/complicações , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Meningioma/complicações , Pessoa de Meia-Idade , Neuralgia do Trigêmeo/diagnósticoRESUMO
This case report presents a patient with chronic orofacial pain who was considered to be an appropriate candidate for chronic opioid therapy, a treatment uncommonly considered at most facial pain centers. Her opioid treatment proved ineffectual, and conservative approaches were addressed. She was successfully tapered off the use of a long-acting opioid within a relatively short time, using an interdisciplinary approach involving an aggressive biobehavioral approach.