Tratamento de dor de cabeça relacionada com a dor miofascial: relato de caso clínico
Management of headache related to myofascial pain: clinical case report
Zamperini, C.A.; Batista, A.U.D.; Oliva, E.A.; Alencar Jr., F.G.P.
Rev. odontol. UNESP, vol.34, n1, p.31-36, 2005
Resumo
As dores de cabeça são sintomas usualmente apontados pelos pacientes que sofrem de desordens temporomandibulares (DTM). Alguns estudos recentes demonstraram uma relação significativa entre cefaléia e sinais e sintomas de desordens temporomandibulares, especificamente com dor miofascial. Quando essa associação ocorre, o tratamento deve ser direcionado para a causa do problema (dor miofascial) ou, com certeza, resultará em insucesso e prejuízos para o paciente. É apresentado o caso clínico da paciente E.P.S., 30 anos, gênero feminino, que compareceu à clínica de Desordens Temporomandibulares da FOAr-UNESP, com queixa principal de dor de cabeça, que se estendia até o pescoço, com intensidade 10 na escala numérica de 1 a 10, freqüência 6x/semana e duração de 2 a 24 horas por dia. Após anamnese e exame físico, foi diagnosticado que a dor de cabeça era atribuída a "trigger-points" localizados nos músculos temporal e esternoclidomastóideo. Foram apresentados a seqüência clínica de diagnóstico e o tratamento do caso em questão, que envolveu aconselhamento, fisioterapia, farmacoterapia e injeção nos "trigger-points", com o restabelecimento da qualidade de vida da paciente.
Palavras-chave
Dor miofascial, cefaléia, diagnóstico
Abstract
Headaches are symptoms usually reported by patients that suffer of tempomandibular disorders (TMD). Some recent studies demonstrated a significant relationship between headaches and signs and symptoms of tempomandibular disorders, specifically with myofascial pain. When this association is present, the treatment should be addressed to the cause of the problem (myofascial pain) or it will certainly result in failure and injuries to the patient. It is presented a clinical case report of a female patient, E.P.S., 30 years-old, that presented to the FOAR–UNESP Temporomandibular Disorders Clinic, with a chief complaint of headache, that extended to the neck, with an intensity of 10, in a numerical scale ranging from 0-10, frequency of 6 days a week, and duration of 2 to 24 hours a day. After anamnesis and clinical examination it was diagnosed that the headache was referred of trigger-points in the temporalis and styernocleidomastoid muscles. We present the complete clinical sequence of diagnosis and treatment of the case, which consisted of counseling, physiotherapy, farmacoteraphy and trigger-points injection, with the recovering of the patient’s quality of life.
Keywords
Myofascial pain, headache, diagnosis
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