ABSTRACT
The primary headaches are composed of multiple entities that cause episodic and chronic head pain in the absence of an underlying pathologic process, disease, or traumatic injury. The most common of these are migraine, tension-type headache, and the trigeminal autonomic cephalalgias. This article reviews the clinical presentation, pathophysiology, and treatment of each to help in differential diagnosis. These headache types share many common signs and symptoms, thus a clear understanding of each helps prevent a delay in diagnosis and inappropriate or ineffective treatment. Many of these patients seek dental care because orofacial pain is a common presenting symptom.
Subject(s)
Headache/diagnosis , Cluster Headache/diagnosis , Cluster Headache/etiology , Cluster Headache/therapy , Headache/etiology , Headache/therapy , Humans , Migraine Disorders/diagnosis , Migraine Disorders/etiology , Migraine Disorders/therapy , Paroxysmal Hemicrania/diagnosis , Paroxysmal Hemicrania/etiology , Paroxysmal Hemicrania/therapy , Tension-Type Headache/diagnosis , Tension-Type Headache/etiology , Tension-Type Headache/therapy , Trigeminal Autonomic Cephalalgias/diagnosis , Trigeminal Autonomic Cephalalgias/etiology , Trigeminal Autonomic Cephalalgias/therapyABSTRACT
OBJECTIVE: This case report highlights the implication of the concept of "geste antagoniste" in conservatively managing oromotor dysfunction and its complications. CLINICAL PRESENTATION: A 66-year-old female with a 1-year history of tardive dyskinesia (TD) was referred to the Craniofacial Pain Department (CPC) at Tufts University School of Dental Medicine for management of sore labial/lingual mucosa secondary to excessive daytime involuntary activity of the tongue, lips, and mandible. A detailed head/neck examination revealed excessive involuntary movements of the tongue, lips, and mandible with generalized tenderness of her masticatory muscles. No TMJ or bone pathology was evident in a panoramic radiograph. INTERVENTION: A lower daytime appliance with bilateral posterior contacts was fabricated to protect her oral mucosa. On reevaluation, excessive movement of the jaw/tongue was significantly reduced with the presence of the appliance in her mouth. Face/neck muscle tenderness was also greatly reduced. CONCLUSION: The use of oral appliance therapy in TD patients plays an important role in protecting the teeth/oral mucosa. The subsequent inhibition of excessive motor activity is proposed and should be further investigated.
