Aim

Headache attributed to temporomandibular disorders and myalgia are two diagnoses included in the diagnostic criteria for temporomandibular disorders (DC/TMD). However, it is not clear if these two diagnoses are different clinical entities given their similar presentation and way in which they are diagnosed, when the myalgia is within the temporalis muscle. The purpose of this retrospective study was to assess the overlap between headache attributed to temporomandibular disorders and myalgia of the temporalis muscle.

Methods

The charts of 671 patients seeking treatment at the Section of Orofacial Pain and Jaw Function, Aarhus University, Denmark, between January 2015 and February 2020 were screened for a diagnosis of headache attributed to temporomandibular disorders, myalgia of the temporalis muscle, or both.

Results

A total of 89 patients fulfilled the DC/TMD criteria for either headache attributed to TMD, myalgia of the temporalis or both. Of these, two had a diagnosis of headache attributed to TMD, 16 of myalgia of the temporalis, and 71 were diagnosed with both. In 97.3% of the times that headache attributed to temporomandibular disorders was diagnosed, the patient was also diagnosed with myalgia of the temporalis. The Jaccard index was 0.8, indicating a substantial overlap between the two diagnoses. Finally, the overlap of pain location between the two diagnoses was substantial, with a Jaccard index of 0.9.

Conclusions

In the present study, headache attributed to temporomandibular disorders was almost exclusively diagnosed together with myalgia of the temporalis. Therefore, we propose that headache attributed to temporomandibular disorders and myalgia of the temporalis muscle have more clinical similarities than differences and as such could be considered one single clinical entity. Further studies will be needed to address the clinical consequences of this proposal.

中文翻译：

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太阳穴疼？头痛、肌肉痛或两者兼有：回顾性分析

目标

归因于颞下颌关节紊乱的头痛和肌痛是颞下颌关节紊乱诊断标准 (DC/TMD) 中包括的两种诊断。然而，当肌痛位于颞肌内时，鉴于它们相似的表现和诊断方式，尚不清楚这两种诊断是否是不同的临床实体。这项回顾性研究的目的是评估颞下颌关节疾病引起的头痛与颞肌肌痛之间的重叠。

方法

对 2015 年 1 月至 2020 年 2 月期间在丹麦奥胡斯大学口面部疼痛和颌功能科寻求治疗的 671 名患者的图表进行了筛查，以诊断出归因于颞下颌关节疾病、颞肌肌痛或两者兼有的头痛。

结果

共有 89 名患者符合 DC/TMD 标准，包括因 TMD 引起的头痛、颞肌痛或两者兼有。其中，2 人诊断出归因于 TMD 的头痛，16 人诊断为颞肌痛，71 人诊断为两者兼有。在 97.3% 的诊断为颞下颌关节紊乱引起的头痛时，患者还被诊断为颞肌痛。Jaccard 指数为 0.8，表明两种诊断之间存在大量重叠。最后，两种诊断之间的疼痛位置重叠很大，Jaccard 指数为 0.9。

结论

在本研究中，归因于颞下颌关节紊乱的头痛几乎完全与颞肌痛一起被诊断出来。因此，我们建议归因于颞下颌关节疾病的头痛和颞肌肌痛具有更多的临床相似性而不是差异，因此可以将其视为一个单一的临床实体。需要进一步的研究来解决该提议的临床后果。