Carotidynia: can anyone provied assistance?

[ahlam21jo]

Hi to all,

I have a patient who diagnosed with Carotidynia, and i dont know what i can do for him, so can you tell me what you think? [email protected]

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[physiobob]

Here a small bit of an extract from a lengthy discussion on this topic. I post this only as a means to define the topic.

Carotidynia: a pain syndrome

Journal of Family Practice, July, 1994 by Lary M. Hill, Glen Hastings

Carotidynia is a common neck pain syndrome first described by Temple Fay in 1927. The pain is typically dull, throbbing, continuous, and localized over the carotid bifurcation, but may radiate to the ipsilateral mandible, cheek, eye, or ear. Symptoms are frequently aggravated by swallowing, chewing, and contralateral head movements. The cardinal physical finding is tenderness on palpation of the carotid bulb, sometimes accompanied by prominence or throbbing of the carotid pulse. Although several serious conditions should be excluded, most cases follow a benign course.

Key words. Carotidynia; migraine; carotid arteries; arteritis; temporal arteritis. (J Fam Pract 1994; 39:71-75)

Carotidynia is a symptom of unilateral vascular neck pain which was first described by Temple Fay in 1927.(1) The cardinal physical finding is tenderness on palpation of the carotid artery. The incidence and prevalence of carotidynia are unknown. Most authors agree that it is common but frequently unrecognized. It may be two or three times as common as cluster headaches.(2)

Lovshin(3) reported a series of 100 cases in patients who ranged in age from 10 to 78 years with a median age of 55 years. Female patients were affected four times as frequently as male patients. In Lovshin's series, as in many others, no serious organic conditions were found among patients presenting with carotidynia, and all were treated symptomatically...........

............
Clinical Characteristics
The pain of carotidynia is most often unilateral and localized to the neck, although radiation to the face, ear, or malar region is not uncommon. It is frequently described as dull and throbbing in character and continuously present, although day-to-day or hour-to-hour exacerbations and remissions are common. Severity varies from mild to agonizing, and the pain is frequently aggravated by swallowing, yawning, coughing, sneezing, or elevating the head while moving it toward the contralateral side. A history of migraine may be present (eg, the first and third cases). In other cases, a history of previous pharyngitis, tonsilitis, upper respiratory tract infection, oral conditions, or recent dental procedures is reported (eg, the second and third cases). Anxiety or fear of cancer is often present.(3)(4)
Physical examination is usually normal except for mild to severe tenderness and sometimes prominent pulsing at the carotid artery bifurcation. Tenderness has also been reported over the proximal 6 cm of the internal carotid or the facial artery. Fay's sign was originally described as follows: "If the thumbs are placed on the common carotid artery just below the bifurcation, and the structures pressed back against the transverse cervical processes with a rolling movement, a severe reaction of pain is produced on the side of the atypical neuralgia. This response I have termed 'carotidynia.'..."(5)............................. ..


In terms of treatment, I suppose after a differential diagnosis then you can treat as per the numerous approaches to migrane?! Anyone else like to offer more specific ideas?