Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Oral medicinePatients appearing to dental professionals with orofacial pain arising from intracranial tumors: a literature review
Section snippets
Material and Methods
The PubMed electronic database was searched for all English-language case reports of orofacial pain that ultimately arose from intracranial tumors. A broad search strategy was employed using any combination of keywords from the following 2 groups: group 1—“oral pain,” “orofacial pain,” “dental pain,” and “dentist”; and group 2: “intracranial tumor,” “brain tumor,” “intracranial malignancy,” “acoustic neuroma,” “cerebellopontine angle lesion,” and “meningioma.” There were no constraints made on
Results
Our search queries produced 871 results with considerable overlap between the many combinations of search prompts.4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 Twenty-nine case reports were found that met our criteria. These cases are summarized in Table I. Ages ranged from 14 to 76 years, with the mean being 43.0 years (SD = 15.0). Sex distribution was slightly skewed toward females, with 59% female (17 of 29) and 41% male (12 of 29).
TN, persistent
Discussion
Our analysis suggests that symptoms of TN, PIFP, and TMD pain are the 3 most common presentations of patients with intracranial tumors. This partly corroborates the study of Bullitt et al.,1 who found that of 13 patients with tumor-induced facial pain, 5 had atypical facial pain (i.e., PIFP) and 8 had TN; however, they did not report any cases of TMD pain.
Conclusions
TN, PIFP, and TMD are 3 common misdiagnoses given to patients with orofacial pain arising from intracranial tumors. A detailed history and physical exam with particular attention to neurologic function, coupled with a comprehensive understanding of orofacial pain syndromes, are requisites for detecting abnormal signs and symptoms. Particular attention should be given to cranial nerve function, areas of unexplained sensory loss, concurrent atypical headaches, and distant neurologic symptoms.
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2014, Journal of the American Dental AssociationCitation Excerpt :Failure to recognize neuropathic complaints and investigate them further is a common mistake that can result in misdiagnosis of a more serious condition such as a malignant neoplasm.3 Another frequent mistake of clinicians is failure to understand that facial pain, even in the presence of an obvious TMD, also can be related to malignant disease.4 The table5–27 is a summary of the literature from 2000 to date describing cases of facial pain, paresthesia or both as the first evident symptoms of intracranial or head and neck malignancies.