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Middle-Aged Man With Recurring Facial Pain.
Publication:
Consultant
Publication Date: 01-DEC-06 |
Format: Online
Delivery: Immediate Online Access |
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Full Article Title: Middle-Aged Man With Recurring Facial Pain.(use of magnetic resonance imaging) |
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Article Excerpt
Byline: Ronald N. Rubin, MD-Series Editor
A 49-year-old man presents with recurring facial pain of 6 months' duration. The pain initially occurred several times per week; it now occurs as often as several times per day. The paroxysmal pain is intense and incapacitating but abates within several minutes. It occurs in the right maxillary region and lower jaw and is sharp and lancinating. Hard chewing and teeth cleaning are the usual precipitating events. Between episodes, the patient is asymptomatic, without numbness or deficit in the affected region.
A thorough review of systems reveals no aura, transient neurologic deficit, or other neurologic symptoms. There is no history of trauma to the region or of any kind of head injury. He has seen a dentist, but the dentist could find no pathology to explain his symptoms.
HISTORY
The patient's health is excellent. He smokes 1 pack of cigarettes every 2 days and drinks alcohol on social occasions. He has no drug allergies. He takes NSAIDs as needed for minor arthritic symptoms.
PHYSICAL EXAMINATION
Vital signs are normal. There is no tenderness to percussion in the temporal or maxillary region...
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