facial pain University of Palestine非典型面部疼痛的巴勒斯坦大学ppt课件.pptVIP

atypical facial pain;DIAGNOSISDiagnosing atypical facial pain is not an easy task. Its not unusual for ATFP patients to have undergone numerous dental procedures, seen multiple doctors and undergone many medical tests before being successfully diagnosed and treated. A diagnosis of ATFP is usually a process of elimination. When a patient complains of constant facial pain restricted to one side of the face, the physician must first rule out any other conditions. Tests include roentgenograms of the skull, MRI and/ or CT scan with particular attention to the skull base, careful dental and otolaryngolgic evaluation, and thorough neurological examination. Only after tests rule out other factors can a diagnosis of ATFP be made. ;TREATMENTSTreatment of ATFP can be difficult and perplexing for both doctor and patient. Medication is usually the first course of treatment. Surgical procedures such as microvascular decompression generally are not successful with ATFP patients. The following drugs are used to treat atypical facial pain: Amitriptyline. (Triptyl, Elavil) ? Gabapentin. (Neurontin). ? Pamelor ? Capsaicin ? Other pain relief strategies include: Hot and cold compresses Acupuncture;Atypical odontalgia; Patients with unrelenting pain in the teeth, gingival, palatal or alveolar tissues often see multiple dentists and have multiple irreversible procedures performed and still have their pain. Up to one-third of patients attending a chronic facial pain clinic have undergone prior irreversible dental procedures for their pain without success. In these cases, if no local source of infectious, inflammatory, or other pathology can be found, then the differential diagnosis must include a focal neuropathic pain disorder. ;The common diagnoses given include the terms atypical odontalgia, persistent orodental pain, or if teeth have been extracted, phantom tooth pain. One possibility is that these pain complaints are due to a neuropathic alteration of the trigeminal nerve. There a