Carotidynia: Diagnosing Carotidynia, Carotidynia Signs and Symptoms, Carotidynia Treatment
Carotidynia is the oldest identified pain condition. Carotidyna can be defined as the neck, face, ear and head pain. The pain is continuous, dull and throbbing and it is felt over the carotid bifurcation (on the temple), the pain may stretch to the ipsiliteral mandible, eye, ear and cheek.
Carotidynia occurs due to dilatation or distention of extracranial arteries on the affected side.Carotidynia is described by experts to be of viral origin. But until now a little is known about Carotidynia. The symptoms of carotiynia aggravate by chewing and swallowing and contralateral movements of head.
Carotiynia neck pain can be confused with tonsillitis, otitis and other neck realted diseases. So the diagnosis should be done carefully for the proper identification from other diseases.
The occurance and cause of carotidynia is unkown. Carotidynia takes place during the cold weather.The pathophysiology of the syndrome is not well known and understood.
Carotidynia is more pevalent in women than in men.
Carotidynia is divided into three classification
It is the most common type, it usually attacks the patient under 60 years of age. It feels acute to the patient even without any personal or family history of migraine. Some patients complain having preceding illness like tonsillitis, pharyngitis and upper respiratory infection and exposure to cold weather. Some classic carotidynia patients have complained of having swollen glands or the sensation and feeling of the presence of foreign bodies in the pharynx. The patient has pain associated with, nasal stuffiness and tearing in the eyes.
his is not the common type and it attacks a patient, under 60 years of age. It is chronic and there is recurrent illness. Many migrainous patients have history of migraine who have undergone treatment.
Arteriosclerotic carotidynia is one of the rarest among the carotidynia varieties but it attacks very seriously and it occurs to patients over 60 years of age. The patients may complain of the suffering with carotid bruits or a palpable carotid mass. A broad and detail family history study of the pateint has to be done focusing on the patient’s other problems such as smoking, hypertension and diabetes. During the attack of Arteriosclerotic carotidynia the patient may have the sensation as if there is a mass in the area of the carotid artery. Some patients report that that they are unable to extend their head away from the affected side, even most of them may black out or feel extremely dizzy while their head is bowed down or angled towards the affected side.
Classic carotidynia, Mgrainous carotidynia and Arteriosclerotic Carotidynia have same physical menifestations. In the classic and arteriosclerotic subtypes, there is tenderness in the common carotid artery, fullness and stuffiness along the affected segment and the carotid sinus is enlarged. In most cases there is absence of distinct mass.
There may not be fever and temporomandibular joint tenderness in any of the three types of carotidynia. There may be slight erythema of the pharynx. Erythema is to be found in most of the patients. The total blood cell counts and erythrocyte sedimentation rates are found to be normal.
The diagnosis of carotidynia is made on clinical studies and observation. The historical study can identify the cause of pain. It can be found by verifying the real cause of pain ; whether due to dental malocclusion or bruxism or TMJ syndrome.
Proper identification of carotidynia is to be made by determining whether it is migrainous, classic or arteriosclerotic in origin. Then treatment becomes easy. Due to wrong diagnosis there is often irregularity and dalay in the treatment of carotidynia.
Anti-inflammatory agents found to be very helpful for the treatment of classic carotidynia. For Instance, indomethacin (Indocin), 50 mg to be given to the patient three times daily for some days. If the case persists then a course of steroids may be recommendated. Prednisone, 30 to 40 mg to be given to the patient daily, after some days it should be reduced according to the symptoms and improvement status.
Migrainous carotidynia usually do not respond to anti-inflammatory agents. Many times steroids are found to be not helpful for the treatment. Drugs such as prophylaxis, ergotamine, methysergide and propranolol found to be helpful for migtranous carotodynia.
Arteriosclerotic carotidynia affects mostly to the people over 60 years of age.The doctor must always examine the patients for carotid bruits and go for a proper vascular history. Thorough Doppler studies and angiography can confirm of the correct diagnosis of the diesease variety, after which careful treatment and right drugs are choosen for the cure.
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