A 33-year-old man complains of an intense aching pain that occurs daily and lasts for about an hour. He outlines the affected area which extends upwards from his right cheek to his forehead. The episodes of intense pain have been going on for about a week. His nose feels blocked and runs when the pain is present. He experienced similar symptoms about 3 months ago which lasted for a couple of weeks and resolved spontaneously.

Pain is unilateral, severe and has occurred previously but age and duration of pain make CTN unlikely, however could be an atypical variant or STN. Associated nasal congestion and rhinorrhea is significant and not usually associated with TN. Therefore, the answer is Cluster headache, but MRI scan indicated in view of suspicion atypical or STN.

RESEARCH

There is evidence to suggest an association between cluster headache and dental problems. Patients with cluster headache often report dental or midfacial pain as a primary presentation, leading to misdiagnosis and unnecessary dental treatments (Egloff et al., 2016). In fact, a study found that many patients with cluster headache were initially examined by a dentist before being diagnosed (Peñarrocha-Diago et al., 2012). Additionally, it is not uncommon for patients with cluster headache to consult a dentist and be misdiagnosed (Byun et al., 2014). Furthermore, some individuals with cluster headache may experience cluster headache-like facial pain following dental extraction (Byun et al., 2014). However, it is important to note that the exact mechanism underlying the association between cluster headache and dental problems is still undetermined (Byun et al., 2014). Further research is needed to better understand this relationship.

REFERENCES

Byun, J., Jung, J., Choi, J. (2014). Cluster Headache-like Facial Pain Following Dental Extraction: a Case Report. Journal of Oral Medicine and Pain, 3(39), 115-118. https://doi.org/10.14476/jomp.2014.39.3.115 Egloff, C., Camelot, F., Pape, E., Scala-Bertola, J., Yasukawa, K., Clement, C. (2016). Diagnostics: Cluster Headache and Misuse Of Paracetamol. Br Dent J, 8(220), 377-377. https://doi.org/10.1038/sj.bdj.2016.279 Peñarrocha-Diago, M., Boronat, A., Peñarrocha-Oltra, D., Ata-Ali, J., Bagan, J. (2012). Clinical Course Of Patients With Episodic Cluster Headache Treated With Corticosteroids Inproximity To the Sphenopalatine Ganglion: A Preliminary Study Of 23 Patients. Med Oral, e477-e482. https://doi.org/10.4317/medoral.17578