Skip to main content
Log in

La douleur orofaciale idiopathique: une douleur fonctionnelle

Idiopathic orofacial pain as functional pain

  • Article de Synthèse / Review Article
  • Published:
Douleur et Analgésie

Résumé

Le concept d’algie orofaciale idiopathique (AOFI) regroupe plusieurs douleurs chroniques de l’extrémité céphalique qui sont souvent très invalidantes (algie faciale atypique, odontalgie atypique, stomatodynie, certaines douleurs musculosquelettiques). Ces pathologies localisées autour de la cavité buccale ne correspondent à aucune cause organique objectivable et pourraient être assimilées à des douleurs « fonctionnelles ». Elles pourraient constituer une seule et même entité physiopathologique affectant des tissus différents. Différents mécanismes physiopathologiques démontrés ou hypothétiques sont décrits.

Abstract

The concept of orofacial idiopathic pain groups together several chronic pain syndromes of the head, which are often very disabling (atypical facial pain, atypical odontalgia, stomatodynia, certain forms of musculoskeletal pain). These orofacial pathologies are not associated with somatic identifiable causes and could be considered as “functional” pain. Such entities might constitute a single pathophysiological entity affecting different tissues. Different pathophysiological mechanisms, already demonstrated or hypothetical, are presented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Références

  1. Aizawa S, Tsukiyama Y, Koyano K, Clark GT (2002) Reperfusion response changes induced by repeated, sustained contractions in normal human masseter muscle. Arch Oral Biol 47:537–543

    Article  PubMed  Google Scholar 

  2. Ashina M, Stallknecht B, Bendtsen L, et al (2002) In vivo evidence of altered skeletal muscle blood flow in chronic tension-type headache. Brain 125:320–326

    Article  PubMed  CAS  Google Scholar 

  3. Bakke M, Möller E (1992) Craniomandibular disorders and masticatory muscle function. Scand J Dent Res 100:32–38

    PubMed  CAS  Google Scholar 

  4. Ballegaard V, Thede-Schmidt-Hansen P, Svensson P, Jensen R (2008) Are headache and temporomandibular disorders related? A blinded study. Cephalalgia 28:832–841

    Article  PubMed  CAS  Google Scholar 

  5. Bendtsen L (2000) Central sensitization in tension-type headache-possible pathophysiological mechanisms. Cephalalgia 20: 486–508

    Article  PubMed  CAS  Google Scholar 

  6. Bodéré C, Tea SH, Giroux-Metges MA, Woda A (2005) Activity of masticatory muscles in subjects with different orofacial pain conditions. Pain 116:33–41

    Article  PubMed  Google Scholar 

  7. Bodere C, Woda A (2008) Effect of a jig on EMG activity in different orofacial pain conditions. Int J Prosthodont 21:253–258

    PubMed  Google Scholar 

  8. Bouhassira D, Attal N, Alchaar H, et al (2005) Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 114:29–36

    Article  PubMed  Google Scholar 

  9. De Santana JM, Sluka KA (2008) Central mechanisms in the maintenance of chronic widespread noninflammatory muscle pain. Curr Pain Headache Rep 12:338–343

    Article  Google Scholar 

  10. Diatchenko L, Slade GD, Nackley AG, et al (2005) Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Hum Mol Genet 14:135–143

    Article  PubMed  CAS  Google Scholar 

  11. Dworkin SF, Le Resche LJ (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. Craniomandib Disord 6:301–355

    CAS  Google Scholar 

  12. Feinmann C (1996) Idiopathic orofacial pain: a multidisciplinary problem: the contribution of psychiatry and medicine to diagnosis and management. In Campbell JN (ed) Pain: an updated review. IASP press Seattle 397–402

    Google Scholar 

  13. Feinmann C, Harris M, Cawley R (1984) Psychogenic facial pain: presentation and treatment. Br Med J 288:436–438

    Article  CAS  Google Scholar 

  14. Forssell H, Tenovuo O, Silvoniemi P, Jääskeläinen SK (2007) Differences and similarities between atypical facial pain and trigeminal neuropathic pain. Neurology 69:1451–1459

    Article  PubMed  Google Scholar 

  15. Forssell H, Soinila S, Puhakka A, et al (2008) Burning mouth syndrome: a peripheral small fiber neuropathy. IASP Glasgow Abstract PH230

  16. Fricton JR (1989) Myofascial pain syndrome. Neurol Clin 7:413–427

    PubMed  CAS  Google Scholar 

  17. Fries E, Hesse J, Hellhammer J, Hellhammer DH (2005) A new view on hypocortisolism. Psychoneuroendocrinology 30:1010–1016

    Article  PubMed  CAS  Google Scholar 

  18. Fumal A, Schoenen J (2008) Tension-type headache: current research and clinical management. Lancet Neurol 7:70–83

    Article  PubMed  CAS  Google Scholar 

  19. Galli U, Gaab J, Ettlin DA, et al (2009) Enhanced negative feedback sensitivity of the hypothalamus-pituitary-adrenal axis in chronic myogenous facial pain. Eur J Pain (sous presse)

  20. Graff-Radford SB, Newman AC (2002) The role of temporomandibular disorders and cervical dysfunction in tension-type headache. Curr Pain Headache Rep 6:387–391

    Article  PubMed  Google Scholar 

  21. Gremeau-Richard C, Woda A, Navez ML, et al (2004) Topical clonazepam in stomatodynia: a randomised placebo-controlled study. Pain 108:51–57

    Article  PubMed  CAS  Google Scholar 

  22. Grushka M (1987) Clinical features of burning mouth syndrome. Oral Surg Oral Med Oral Pathol 63:30–36

    Article  PubMed  CAS  Google Scholar 

  23. Harris M (1996) Idiopathic orofacial pain: a management overview. In: Campbell JN (ed) An updated review. IASP Press Seattle 403–412

    Google Scholar 

  24. Jääskeläinen SK, Forssell H, Tenovuo O (1999) Electrophysiological testing of the trigeminofacial system: aid in the diagnosis of atypical facial pain. Pain 80:191–200

    Article  PubMed  Google Scholar 

  25. Janal MN, Raphael KG, Nayak S, Klausner J (2008) Prevalence of myofascial temporomandibular disorder in US community women. J Oral Rehabil 35:801–809

    Article  PubMed  CAS  Google Scholar 

  26. Julien N, Goffaux P, Arsenault P, Marchand S (2005) Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition. Pain 114:295–302

    Article  PubMed  Google Scholar 

  27. Lamey PJ, Freeman R, Eddie SA, et al (2005) Vulnerability and presenting symptoms in burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Oral Endod 99:48–54

    Article  Google Scholar 

  28. Larheim TA (2005) Role of magnetic resonance imaging in the clinical diagnosis of the temporomandibular joint. Cells Tissues Organs 180:6–21

    Article  PubMed  Google Scholar 

  29. Lauria G, Majorana A, Borgna M, et al (2005) Trigeminal smallfiber sensory neuropathy causes burning mouth syndrome. Pain 115:332–337

    Article  PubMed  Google Scholar 

  30. Lauritano D, Spadari F, Formaglio F, et al (1998) Etiopathogenic, clinical-diagnostic and therapeutic aspects of the burning mouth syndrome. Research and treatment protocols in a patient group. Minerva Stomatol 47:239–251

    PubMed  CAS  Google Scholar 

  31. Le Resche L, Saunders K, Von Korff MR, et al (1997) Use of exogenous hormones and risk of temporomandibular disorder pain. Pain 69:153–160

    Article  Google Scholar 

  32. List T, Leijon G, Helkimo M, et al (2006) Effect of local anesthesia on atypical odontalgia: a randomized controlled trial. Pain 122:306–314

    Article  PubMed  CAS  Google Scholar 

  33. Liu ZJ, Yamagata K, Kasahara Y, Ito G (1999) Electromyographic examination of jaw muscles in relation to symptoms and occlusion of patients with temporo-mandibular joint disorders. J Oral Rehabi 26:33–47

    Article  CAS  Google Scholar 

  34. Mock D, Frydman W, Gordon AS (1985) Atypical facial pain: a retrospective study. Oral Surg Oral Med Oral Pathol 59:472–474

    Article  PubMed  CAS  Google Scholar 

  35. Okeson, JP (1996) Orofacial pain: guidelines for assessment, classification, and management. Chicago: Quintessence

    Google Scholar 

  36. Parker MW, Holmes EK, Terezhalmy GT (1993) Personality characteristics of patients with temporomandibular disorders: diagnostic and therapeutic implications. J Orofac Pain 7:337–344

    PubMed  CAS  Google Scholar 

  37. Pfaffenrath V, Rath M, Pöllmann W, Keeser W (1993) Atypical facial pain: application of the IHS criteria in a clinical sample. Cephalalgia 12:84–88

    Google Scholar 

  38. Scala A, Checchi L, Montevecchi M, et al (2003) Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol 14:275–291

    Article  CAS  Google Scholar 

  39. Schille H (1986) Injuries of the temporomandibular joint: classification, diagnosis and fundamentals of treatment In: Kruger E, Schilli W (eds). Oral and maxillofacial Traumatology, vol 2. Chicago: Quintessence

    Google Scholar 

  40. Staud R, Vierck CJ, Cannon RL, et al (2001) Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain 91:165–175

    Article  PubMed  CAS  Google Scholar 

  41. Svensson P, Bak J, Troest T (2003) Spread and referral of experimental pain in different jaw muscles. J Orofac Pain 17:214–223

    PubMed  Google Scholar 

  42. Svensson P (2007) Muscle pain in the head: overlap between temporomandibular disorders and tension-type headaches. Curr Opin Neurol 20:320–325

    Article  PubMed  Google Scholar 

  43. Vickers ER, Cousins MJ, Walker S, Chisholm K (1998) Analysis of 50 patients with atypical odontalgia. A preliminary report on pharmacological procedures for diagnosis and treatment. Oral Surg Oral Med Oral Pathol 85:24–32

    CAS  Google Scholar 

  44. Wessely S, Nimnuan C, Sharpe M (1999) Functional somatic syndromes: one or many? Lancet 354:936–939

    Article  PubMed  CAS  Google Scholar 

  45. Woda A, Tubert-Jeannin S, Bouhassira D, et al (2005) Towards a new taxonomy of idiopathic orofacial pain. Pain 116:396–406

    Article  PubMed  Google Scholar 

  46. Woda A, Grémeau-Richard C, Augagneur A (2007) La stomatodynie: une pathologie neuropathique dégénérative induite par des modifications stéroïdiennes ? In: La douleur neuropathique et ses frontières. Bouhassira D Med-Line Edition Paris, pp. 115–132

  47. Woda A, Grémeau-Richard C (2008) Les douleurs orofaciales idiopathiques: quelle conduite à tenir ? In: Bonnet F, Bouhassira D. 33 nouveaux concepts qui ont marqué l’évolution de la prise en charge de la douleur ces 15 dernières années ? Éditions scientifiques LC Paris, pp. 38–42

  48. Woda A, Pionchon P (2009) Les douleurs orofaciales idiopathiques. In: Biologie de la douleur. Bouhassira D. Calvino B. Douin-Arnette Paris (sous presse)

  49. Woda A, Pionchon P (2001) Tableau sémiologique et hypothèses physiopathologiques des algies orofaciales idiopathiques. Rev. Neurol 57:265–283

    Google Scholar 

  50. Woda A, Pionchon P (2000) A unified concept of idiopathic orofacial pain. Patho-physiological features. J Orofacial Pain 14(3): 196–212

    PubMed  CAS  Google Scholar 

  51. Woda A, Pionchon P (2007) Nociception and chronic oral and cervicofacial pain. Ann Otolaryngol Chir Cervicofac 124(Suppl 1):2–10

    Article  Google Scholar 

  52. Yilmaz Z, Renton T, Yiangou Y, et al (2007) Burning mouth syndrome as a trigeminal small fibre neuropathy: increased heat and capsaicin receptor TRPV1 in nerve fibres correlates with pain score. J Clin Neurosci 14:864–871

    Article  PubMed  CAS  Google Scholar 

  53. Zakrzewska JM (1995) The burning mouth syndrome remains an enigma. Pain 62:253–257

    Article  PubMed  CAS  Google Scholar 

  54. Zhou Z, Zhu G, Hariri AR, et al (2008) Genetic variation in human NPY expression affects stress response and emotion. Nature 24:997–1001

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Bodéré.

About this article

Cite this article

Bodéré, C., Woda, A. La douleur orofaciale idiopathique: une douleur fonctionnelle. Douleur analg 22, 89–95 (2009). https://doi.org/10.1007/s11724-009-0130-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11724-009-0130-y

Mots clés

Keywords

Navigation