Recently, it has been recognized that temporomandibular disorders may include not only jawrelated musculoskeletal disorders but also orofacial pain. Further, the signs and symptoms of orofacial pain closely resemble those of the temporomandibular musculoskeletal disorders, which leads to much confusion and misdiagnosis. Therefore, it is necessary to expand the scope from temporomandibular joint disorders to orofacial pain, including neurovascular pain and neuropathic pain. In this article, a case of continuous neuropathic pain exhibiting temporomandibular joint pain is described.
The case was a 53-year-old male whose right side temporomandibular joint pain was initially diagnosed as a temporomandibular joint disorder by a general dentist and was not ameliorated by common occlusal treatment and anti-inflammatory drug therapy.
Since his pain was characterized by sudden bursts of electric-like pain, episodic neuropathic pain was doubted, carbamazepine (initially 100 mg/day, up to 800 mg/day) and bacrofen (15 mg/day) were administered, and serological monitoring of carbamazepine was performed. These medications worked very well, ameliorating his pain.