medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2019-4-35(410)-40-46medalphabet-1363Research ArticleСтатьиДисфункция височно-нижнечелюстного сустава и другие причины боли в лице: первая международная классификация и новые подходы к терапииTemporomandibular disorder and other causes of orofacial pain: first international classification and new treatment perspectivesЛатышеваН. В.LatyshevaN. V.

к. м. н., доцент кафедры нервных болезней

ФилатоваЕ. Г.FilatovaE. G.

д. м. н., проф.

ДаниловАл. Б.DanilovAl. B.

д. м. н, проф., зав. кафедрой нервных болезней института проф. образования

г. Москва

Moscow

ПарсамянР. Р.ParsamyanR. R.

к. м. н., директор

СалинаЕ. А.SalinaE. A.

к. м. н., врач-невролог

ФГАОУ ВО «Первый Московский государственный медицинский университет имени И. М. Сеченова (Сеченовский университет)» Минздрава России; Клиника головной боли и вегетативных расстройств имени академика Александра Вейна, г. МоскваРоссияSechenov University; Alexander Vein Headache Clinic, MoscowRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет имени И. М. Сеченова (Сеченовский университет)» Минздрава РоссииРоссияSechenov UniversityRussian FederationФГБОУ ВО «Саратовский государственный медицинский университет имени В. И. Разумовского» Минздрава России; «Клиника лечения боли», г. СаратовРоссияSaratov State Medical University n. a. V. I. Razumovsky; Pain Clinic, SaratovRussian Federation201921012020435Обозрение4046Copyright © Латышева Н.В., Филатова Е.Г., Данилов А.Б., Парсамян Р.Р., Салина Е.А., 20202020Латышева Н.В., Филатова Е.Г., Данилов А.Б., Парсамян Р.Р., Салина Е.А.Latysheva N.V., Filatova E.G., Danilov A.B., Parsamyan R.R., Salina E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1363

Диагностика и лечение боли в лице зачастую представляет собой серьезную проблему вследствие сложностей сбора анамнеза, многогранного патогенеза, а также наличия сопутствующей патологии, в первую очередь психических заболеваний и психосоциальных факторов. В настоящее время наблюдается серьезная гипердиагностика невралгии тройничного нерва. В то же время причинами боли в лице могут быть и другие виды нейропатической боли, а некоторые формы дисфункции височно‑нижнечелюстного сустава вообще не фигурируют в диагнозах. Правильная диагностика причины боли в лице важна не только для выбора оптимальной терапии, но и для минимизации риска нежелательных явлений. Кроме того, было показано, что орофациальная боль при отсутствии лечения часто переходит в хроническую форму и становится резистентной к лечению. Для многих пациентов в данном случае потребуются нелекарственные методы терапии, фармакотерапия и психологическая поддержка. Целью статьи является обзор новой классификации орофациальной боли, а также распространенности, патогенеза и подходов к лечению дисфункции височно‑нижнечелюстного сустава, тригеминальной невралгии, персистирующей идиопатической лицевой боли, синдрома пылающего рта и других форм орофациальной боли.

The diagnosis and treatment of orofacial pain is in many cases a complex task due to difficulties in history taking, multi‑faceted pathology, psychiatric comorbidities and psychosocial factors involved in such pain. Neurologists tend to overdiagnose trigeminal neuralgia. However, other types of neuropathiс orofacial pain are also common. Moreover, neurologists are often unfamiliar with the temporomandibular disorder and tend to neglect this extremely prevalent cause of orofacial pain. Correct understanding of the causes of orofacial pain is vital not only for treatment selection, but also to minimize the risk of adverse events associated with unnecessary madications. Moreover, untreated orofacial pain often becomes chronic and treatment resistant. Many patients in this case would require physical therapy, pharmacological treatments, cognitive behavioral therapy and other support options. The aim of this paper is to review the new International classification of orofacial pain as well as the prevalence, pathophysiology and treatment of the temporomandibular disorder, trigeminal neuralgia, persistent idiopathic facial pain, burning mouth syndrome and other forms of orofacial pain.

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The authors declare that there are no conflicts of interest present.