Peer Reviewed

What's the Take Home?

A 52-Year-Old Woman With Episodes of Severe Jaw and Cheek Pain

Volume 61 - Issue 4 - April 2021

  • AUTHOR:
    Ronald N. Rubin, MD1,2—Series Editor

    AFFILIATIONS:
    1Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
    2Department of Medicine, Temple University Hospital, Philadelphia, Pennsylvania

    CITATION:
    Rubin RN. A 52-year-old woman with episodes of severe jaw and cheek pain. Consultant. 2021;61(4):e16-e18. doi:10.25270/con.2021.03.00021

    DISCLOSURES:
    The author reports no relevant financial relationships.

    CORRESPONDENCE:
    Ronald N. Rubin, MD, Temple University Hospital, 3401 N Broad St, Philadelphia, PA 19140 (blooddocrnr@yahoo.com)

     

    A previously healthy 52-year-old woman presented for evaluation of painful episodes involving her right jaw and cheek. These symptoms started about a year ago but have become more frequent and prolonged since then. They are characterized by an abrupt onset of “shooting, stabbing” pain impulses that each last seconds (although, the entire length of the episode is measured in hours). The episodes essentially always involve the right cheekbone and jaw.

    The patient was not sure what elicited them but, in the ensuing year, noticed that tooth brushing and a wind or breeze, especially in the winter, across her face could lead to an episode. She had previously seen a dentist, who performed very minor dental work. The completion of the work had no effect on her symptoms. The patient also saw an oral surgeon, who prescribed mechanical mouth pieces and analgesics for temporomandibular joint disorder, which also had no effect.

    She was otherwise very healthy, with no major diagnoses and no chronic medications. She works as a librarian without difficulty except when an episode occurs, which severely incapacitates her.

    Findings from a physical examination, including a detailed neurological examination, are within normal limits, as are results from a recent complete blood cell count and complete metabolic panels.

     

     

    Answer and discussion on next page.

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