Abstract
Aim: To report a difficult case of medication-overuse headache complication in a patient with orofacial pain following dental treatment.
Case: A patient in her 60s had undergone repair of the left upper first premolar that had lost a filling by a dentist about 6 months prior. As root canal treatment was initiated, the patient started experiencing pain on the left side of the head and face. As she experienced no improvement of symptoms, she visited an otology clinic for a detailed examination, but no cause was identified. Subsequently, the patient was referred to our hospital. At that time, she was frequently taking prescribed loxoprofen. No acute inflammation was found in the tooth, therefore the pain was suspected to be associated with myofascial pain of the left temporal muscle. Simultaneously, the patient suffered an ankle fracture. She underwent treatment in an orthopedic surgery department, which used loxoprofen to treat the pain. Subsequently, head and face pain on the left side worsened. Because the cause was not identified, the patient was referred to the pain clinic department of a general hospital. By then the patient was suffering from tension headache and took analgesics on a daily basis. Based on this, medication-overuse headache was suspected. Loxoprofen was immediately discontinued and goreisan was prescribed as an alternative. Thereafter, the head and face pain on the left side almost disappeared.
Conclusion: Medication-overuse headache may occur due to the overuse of medication in patients with primary headache. Prior to prescribing analgesics, dentists need to understand the patient’s past history of headaches. Drug administration without due consideration should be avoided. Additionally, the patient should also be informed of the risk of medication-overuse headache.
