Protocolo diagnóstico de los dolores faciales y nucales

Abstract

Facial and nuchal pain are caused mostly (90%) by structural causes (visceral pain), like glaucoma, sinusitis, odontalgia, cervicopathies, etc., and primary headaches syndromes, mainly migraine and tension type headache. Nevertheless, rarely conditions, some of them potentially dangerous, have to be taken into account (arterial dissection, trigeminal-autonomic cephalalgias, Chiari malformation, temporary arteritis, temporomandibular joint dysfunction, etc.). Finally, 10% of this type of pain is neuropathic, being mainly related to trigeminal and occipital neuralgias. However, terminal branch neuralgias of the trigeminal nerve, glossopharyngeal neuralgia, or persistent idiopathic facial pain have to be considered too. Herein, a diagnosis approach for mainly facial and nuchal pains is performed. Differential diagnosis is also developed.