측두하악장애와 편두통

Abstract

Temporomandibular disorders is a collective term embracing a number of clinical problems that in- volve the temporomandibular joint(TMJ), the masticatory muscles, and associated structures. Myofascial pain, one of the most common diagnosis in the TMD classification, is characterized by a regional, dull, aching muscle pain and the presence of localized trigger points in muscle, tendon, or fascia and it has been known as a pathogenetic factor in tension-type headache and migraine. According to the previous studies, the central sensitization following continuous nociceptive input of myofascial pain may play a important role in the pathogenesis of migraine and the mechanisms probably involves activation of N-Methyl-D-Aspartate(NMDA) receptors and production of Nitric Oxide(NO). Therefore the therapy for myofascial pain enhancing central inhibition through pharmacological mana- gement or behavioral interventions and simultaneously reducing peripheral inputs through physical therapies, orthopedic appliances and trigger point injections, can be considered as an effective treatment in migraine patients with myofascial pain.