CLINICAL ASPECTS OF DIFFERENTIAL DIAGNOSIS OF MIGRAINE AND PAIN SYNDROME ASSOCIATED WITH TEMPOROMANDIBULAR JOINT DYSFUNCTION: AN EXPERT REVIEW FOR OUTPATIENT PRACTICE (Review Article)
Keywords:
migraine; temporomandibular joint dysfunction; craniofacial pain; differential diagnosis; clinical markers; outpatient practiceAbstract
Background. Differentiation between migraine and somatic migraine-like pain in outpatient neurology remains challenging, especially in the absence of instrumental diagnostic methods. Temporomandibular joint dysfunction, often combined with myofascial pain of the masticatory muscles, represents a frequent somatic source of migraine-like headache. Objective. To summarize and systematize clinically relevant markers with the highest diagnostic value for distinguishing migraine from temporomandibular disorder–related pain in outpatient neurological practice. Materials and methods. This expert review is based on international classifications (ICHD-3, DC/TMD), clinical guidelines, key studies on migraine, craniofacial pain, and temporomandibular disorders, as well as the author’s clinical experience. Results. The most diagnostically informative features include pain modulation by masticatory function, reproducibility of pain on palpation of masticatory muscles, fluctuating temporal pain patterns, and instability of autonomic symptoms. Conclusion. Systematic assessment of combined clinical markers enables reliable differentiation between migraine and temporomandibular disorder–related pain without instrumental diagnostics and facilitates identification of comorbid conditions.
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