BACKGROUND: Headaches (HAs) and temporomandibular joint dysfunction (TMD) are common comorbidities, and the presence of one of them in a patient increases the incidence of the other. The relationship between these 2 conditions may involve common pathophysiological processes. Considering the topicality of the problem, it is justified to conduct research in this field. In this study, we assessed HA type and severity in people with TMD.
OBJECTIVE: The aim of the study was to conduct qualitative and quantitative assessments of HAs in people with temporomandibular joint (TMJ) disorders.
METHODS: The study group consisted of 51 subjects of both sexes with a TMD diagnosed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) test. A self-report questionnaire was utilized to self-assess the presence of TMD symptoms, while the standardized Short-Form of the McGill Pain Questionnaire was used to qualitatively and quantitatively assess HAs.
RESULTS: People with TMD were significantly more likely to report HA occurrences (p < 0.001). Pain intensity was statistically significantly higher among individuals with TMD compared to those without TMD symptoms (p < 0.001). Most often, the HA was associated with a pressing pain (r = 0.82) and least often, it was described as cutting (r = 0.30). Neck and shoulder girdle pain (p = 0.059; 82.9%) and clenching and/or grinding of teeth (p = 0.021; 92.7%) were significantly more common among patients who declared HAs than among those without HAs. The results obtained so far may indicate a significant relationship between HA and TMD.
CONCLUSIONS: We have described the relationship between the occurrence of HAs and TMD. Headaches are more frequent and more severe in people with TMD.

BACKGROUND: When secondary headache is suspected and the patient is referred to the emergency department or to the outpatient neurology clinic, it is important to know which are the appropriate complementary examinations to perform and the suitable referral pathway for patients to follow. In order to establish recommendations on this matter, the Spanish Society of Neurology\'s Headache Study Group (GECSEN) has decided to issue a series of agreed recommendations constituting a referral protocol for patients with headache and/or craniofacial neuralgias.
METHODS: Young neurologists with an interest and experience in headache were invited to draft a series of practical guidelines in collaboration with GECSEN\'s Executive Committee. For practical reasons, the document was divided into 2 articles: the first focuses on primary headaches and craniofacial neuralgias and this second article on secondary headaches and other craniofacial pain. In order for the recommendations to be helpful for daily practice, they follow a practical approach, with tables summarising referral criteria, examinations to be performed, and referral to other specialists.
CONCLUSIONS: We hope to offer a guide and tools to improve decision-making regarding patients with headache, identifying complementary tests to prioritise and referral pathways to be followed, in order to avoid duplicated consultations and delayed diagnosis and treatment.

OBJECTIVE: Determinants for orofacial pain, headache, morning headache and painful signs of temporomandibular disorders (TMD) were investigated in prepubertal children.
METHODS: The participants were a population sample of 439 children aged 6-8 years. Craniofacial pains, eating meals and snacks, sleep bruxism, sleep quality, sleep-disordered breathing (SDB), psychological well-being, parental education and household income were assessed by questionnaires filled out by the parents. Sleep duration was assessed using a combined heart rate and movement sensor and clinical signs of TMD and dental occlusion by a dentist. The determinants of pain conditions were analyzed using logistic regression.
RESULTS: Of all 439 children, 26% had experienced orofacial pain and 31% headache during the past 3 months, 17% had suffered morning headache weekly and 13% had painful signs of TMD in a clinical examination. Restless sleep was associated with increased risk of orofacial pain, the painful signs of TMD and restless sleep with increased risk of headache and restless sleep, sleep bruxism and skipping meals with increased risk of morning headache after adjustment for other independent determinants of these pain conditions. Headache was associated with increased risk for painful signs of TMD.
CONCLUSIONS: Craniofacial pains are common among prepubertal children. Prepubertal children with sleep bruxism, restless sleep and skipping meals have increased likelihood of craniofacial pains.

BACKGROUND: Temporomandibular disorders (TMD) are the most common non-dental cause of orofacial pain with a multifactorial aetiology.
OBJECTIVE: To evaluate the head and craniocervical posture between individuals with and without TMD and its sub types by photographic and radiographic method.
METHODS: Thirty four TMD patients diagnosed according to Research Diagnostic Criteria for TMD\'s (RDC/TMD) and were divided into 2 groups: Group I (muscle disorder), Group II (disc displacement). Control group comprised of 34 age and sex matched subjects without TMD. Lateral view photographs were taken and the head posture angle was measured. Craniocervical posture was assessed on lateral skull radiograph with two angles (Craniocervical Angle, Cervical Curvature Angle) and two distances (Suboccipital Space, Atlas-Axis Distance). To compare the results, t-test was used with significance level of 0.05.
RESULTS: Head posture showed no statistical significant difference (p > 0.05) between Group I, II and control group in both photographic and radiographic methods. The cervical curvature angle showed significant difference (p = 0.045) in Group I only. Atlas-Axis Distance was statistically significant in Group II (p = 0.001).
CONCLUSIONS: The present study confirmed that there is a negative association of head posture and TMD whereas, cervical lordosis was present in Group I only.