Carotidynia Versus Transient Perivascular Inflammation of the Carotid Artery (TIPIC) Syndrome: Finding Common Ground.

Sheldon P Hersh,Perry Gerard,Joshua Hersh

doi:10.7759/cureus.17684

Abstract

Carotidynia remains mired in controversy. Whether to identify this self-limiting unilateral neck pain as a distinct clinical entity or a diagnostic sign associated with a variety of conditions remains a topic of ongoing debate. Adding to the discussion is the occasional finding on imaging studies of a transient inflammatory process surrounding the carotid artery in a number of individuals who present with unilateral neck pain. Although some use carotidynia as the designation of choice by which to identify this inflammatory process, the acronym TIPIC (transient perivascular inflammation of the carotid artery) syndrome is being touted as a far more descriptive and less contentious alternative. Having TIPIC syndrome replace carotidynia, however, need not necessarily signal the latter’s outright elimination as some have advocated. When used as a diagnostic sign, carotidynia provides an appreciation of the many conditions that may be associated with idiopathic unilateral neck pain.

Highlights

Carotidynia, a term first introduced by Fay in 1927 [1], was so named to describe the pain and tenderness associated with the application of pressure on or about the area of the carotid bifurcation (Fay’s Sign)
The term carotidynia was first introduced by Fay in 1927 with the clear intention that it be used as a “diagnostic sign” by which to isolate possible “sites of involvement” in cases of atypical facial neuralgia [1]
The term carotidynia was initially intended to serve as a diagnostic aid in cases of atypical facial neuralgia, its identity continues to vacillate between that of a diagnostic symptom commonly associated with an array of diverse conditions and a distinct clinical entity

Summary

Introduction

Carotidynia, a term first introduced by Fay in 1927 [1], was so named to describe the pain and tenderness associated with the application of pressure on or about the area of the carotid bifurcation (Fay’s Sign). Calling carotidynia “confusing”, Lecler et al [5] coined the term TIPIC (Transient Perivascular Inflammation of the Carotid Artery) syndrome as a preferable alternative. These authors have joined others [6] in calling for the term carotidynia to be removed entirely from use. Once so accepted and identified, carotidynia can work in concert with TIPIC syndrome and provide complementary perspectives on how best to approach idiopathic unilateral neck pain. The patient denied any antecedent or concurrent symptoms relating to an upper respiratory infection or regional inflammatory process She had remained afebrile from the time the pain first appeared. The patient sought consultation elsewhere and was lost to follow-up

Discussion

Conclusions

Disclosures