Current Issue Subscriptions
Back Issues Advertising
More Information Classified Ads
For Authors Continuing Education
Vol. 73, No. 2
ISSN: 1488-2159
March 2007


Sympathetically Maintained Pain Presenting First as Temporomandibular Disorder, then as Parotid Dysfunction


Listen to the interview with Dr. Donald Nixdorf
 Speaker icon
 3 minutes and 14 seconds

• Subha Giri, BDS, MS •
• Donald Nixdorf, DDS, MS •

A b s t r a c t

Complex regional pain syndrome (CRPS) is a chronic condition characterized by intense pain, swelling, redness, hypersensitivity and additional sudomotor effects. In all 13 cases of CRPS in the head and neck region reported in the literature, nerve injury was identified as the etiology for pain initiation. In this article, we present the case of a 30-year-old female patient with sympathetically maintained pain without apparent nerve injury. Her main symptoms — left-side preauricular pain and inability to open her mouth wide — mimicked temporomandibular joint arthralgia and myofascial pain of the masticatory muscles. Later, symptoms of intermittent preauricular pain and swelling developed, along with hyposalivation, which mimicked parotitis. After an extensive diagnostic process, no definitive underlying pathology could be identified and a diagnosis of neuropathic pain with a prominent sympathetic component was made. Two years after the onset of symptoms and initiation of care, treatment with repeated stellate ganglion blocks and enteral clonidine pharmacotherapy provided adequate pain relief.


MeSH Key Words: complex regional pain syndrome; pain, intractable; parotitis; temporomandibular joint disorders
Reply to this article | View replies [0]

Full text provided in PDF format


Mission Statement & Editor's Message | Multimedia Centre | Readership Survey
Contact the Editor | Français