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Persistent idiopathic facial pain: multidisciplinary approach and assumption of comorbidity

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Abstract

Persistent idiopathic facial pain (PIFP) is a complex and uncertain nosographic entity, which has many aspects that need to be explored. The 21 patients selected (male 4 and female 17, mean age 40 years) were under electromyography (EMG) to determine the efficiency of the masseter muscles (MM) and the anterior temporalis muscles (TA), during activity and at rest, and under kinesiography (CMS) to identify the physiological rest position of the mandible after TENS stimulation. These patients were rehabilitated with a neuromuscular orthosis to provisionally correct the discrepancies identified. The EMG mean values of the muscles at rest were significantly above the normal (two-sample t test) for all four muscles and were normalized after the TENS session (Wilcoxon rank test). CMS showed that all 21 patients needed a mandibular advancement and 90.5% a correction in the frontal plane, obtained with orthosis. The comparison between the values of the maximal clench on natural dentition and on the orthosis showed a decrease in the asymmetry of muscular strength (−30.21% for TA and −55.81% for MM; Wilcoxon rank test) and a net increase of the strength expressed (LTA +25.37; LMM +59.40%, RMM +40.80%, RTA +30.27; Wilcoxon rank test; sign test). Preliminary results show a net decrease also in VAS pain score with a mean shift from 9.5 to 3.1. The results suggest a role for the neuromuscular component of the craniomandibular system in the pathogenesis of chronic idiopathic facial pain. All patients with PIFP should undergo the CMS–EMg examination.

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Conflict of interest statement

The authors declare that they have no conflict of interest related to the publication of this article.

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Authors and Affiliations

  1. Fondazione IRCCS Cà Granda, Dipartimento di Scienze Chirurgiche Ricostruttive e Diagnostiche Sezione di Odontostomatologia, Università degli Studi di Milano, Milan, Italy

    H. Didier, C. Marchetti, Giulia Borromeo & F. Santoro

  2. Clinical Neurosciences Department, Carlo Besta Neurological Institute IRCCS Foundation, Milan, Italy

    V. Tullo & G. Bussone

  3. Policlinico, Mangialli e Regina Elena IRCCS Foundation, Dental Clinic, Via della Commenda 10, 20122, Milan, Italy

    Giulia Borromeo

Authors
  1. H. Didier
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  2. C. Marchetti
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  3. Giulia Borromeo
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  4. V. Tullo
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  5. G. Bussone
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  6. F. Santoro
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Correspondence to Giulia Borromeo.

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Didier, H., Marchetti, C., Borromeo, G. et al. Persistent idiopathic facial pain: multidisciplinary approach and assumption of comorbidity. Neurol Sci 31 (Suppl 1), 189–195 (2010). https://doi.org/10.1007/s10072-010-0324-3

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  • DOI: https://doi.org/10.1007/s10072-010-0324-3

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