Auriculotemporal neuralgia

School of Medicine, University of Sao Paulo at Ribeirao Preto, Department of Neurology, Psychiatry, and Medical Psychology, Av. Bandeirantes, 3900 Ribeirao Preto, Sao Paulo CEP 14049-900, Brazil.
Current Pain and Headache Reports (Impact Factor: 2.26). 09/2005; 9(4):277-80. DOI: 10.1007/s11916-005-0037-0
Source: PubMed


In this article, the anatomic and physiologic characteristics and clinical syndromes involving the auriculotemporal nerve (ATN) are reviewed. The ATN is a terminal branch of the mandibular nerve (third division of the trigeminal nerve). The syndrome of ATN neuralgia (ATNa), which is characterized by attacks of paroxysmal, moderate to severe pain on the preauricular area, often spreading to the ipsilateral temple, is discussed in this article. The classification of ATNa under the Second Edition of the International Classification of Headache Disorders, as well as our personal experience in diagnosing and treating this syndrome, also are reviewed.

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    • "This is characterized by hyperaesthesia, redness, increased temperature or sweating along the distribution of the auriculotemporal nerve and/or major auricular nerve, associated with the intake of foods that stimulate salivation (Benedittis 1990). Another rare disease affecting this nerve is AN (Speciali & Gonç alves 2005). At the International Classification of Headaches (ICHD-II) (Headache Classification Commitee of the Internacional Headache Society 2004), AN is not cited as a sub item, but it fulfils the criteria for item 13.7 'Other terminal branch neuralgias' (Table 1). "
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    ABSTRACT: Aim To present a 52-year-old male patient who complained of intense pain of short duration in the region of the left external ear and in the ipsilateral maxillary second molar that was relieved by blockade of the auriculotemporal nerve in the infratemporal fossa. Summary Extra- and intraoral physical examination revealed a trigger point that reproduced the symptoms upon finger pressure in the ipsilateral auriculotemporal nerve and in the outer auricular pavilion. The patient’s medical history was unremarkable. The maxillary left second molar tooth was not responsive to pulp sensitivity testing and there was no pain upon percussion or palpation of the buccal sulcus. Periapical radiographs revealed a satisfactory root filling in the maxillary left second molar. On the basis of the clinical signs and symptoms, the auriculotemporal was blocked with 0.5 mL 2% lidocaine and 0.5 mL of a suspension containing dexamethasone acetate (8 mg mL−1) and dexamethasone disodium sulfate (2 mg mL−1), with full remission of pain 6 months later. The diagnosis was auriculotemporal neuralgia. Key learning point
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    ABSTRACT: Temporomandibular joint disorders (TMD) is a collective term used to describe pathologic conditions involving temporomandibular joint (TMJ), masticatory muscles and associated structures. Common related complaints include local pain, limited mouth opening and TMJ noises whereas symptoms often associated to TMD with debated pathogenesis enclose earache, headaches, tinnitus and trigeminal-like symptoms such as atypical orofacial pain. In particular, TMD trigeminal associated symptoms are intricate, difficult to treat and exert a great impact on everyday life of the patients thus invoking a complex multidisciplinary treatment. In this paper, the authors analyze the anatomic and topographic relationships between the mandibular branch of the trigeminal nerve and the medial aspect of the TMJ capsule in 8 fresh adult cadavers thus resuming a pathologic relationship between atypical trigeminal symptoms and TMD.
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    ABSTRACT: Clinical experience with surgical decompression of specific peripheral nerves in the head and neck for the relief of migraine headache symptoms has proven to be effective in most patients. Some patients, however, continue to have residual symptoms after these procedures. In an effort to better understand potential etiologies for failure of treatment, an investigation was performed to determine whether or not vascular-mediated peripheral trigger points exist that have heretofore been undescribed that may be contributing to persistent symptomatology. One such potential trigger point is the superficial temporal artery's interaction with the auriculotemporal nerve. A cadaveric investigation was performed to advance this anatomical understanding of this relationship. Both sides of 25 fresh cadaveric heads were dissected in the preauricular and temporal regions. The superficial temporal artery and auriculotemporal nerve were identified and dissected both proximally and distally. Their relationship was examined, and a topographical map of their intersections was generated. The auriculotemporal nerve and superficial temporal artery run together in the superficial soft tissue in the preauricular and temple regions. A contiguous relationship between the two was found in 17 hemiheads (34.0 percent). There are variations in the relationship between the auriculotemporal nerve and the superficial temporal artery. These variations may serve as an anatomical explanation for this point as a source of migraine headaches in some patients. A topographical map of the relationship between these two structures may serve as a guide for surgeons interested in decompressing the nerve from the artery when indicated.
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