偏头痛合并颞下颌关节紊乱的共病机制及临床诊疗意义OA

Migraine is a common primary headache disorder with a high disability burden,and temporomandibular disorders(TMD)are among the most prevalent chronic pain conditions in the orofacial region.Studies have shown a sig-nificant bidirectional comorbidity between migraine and TMD,with pain-related TMD being particularly closely associated with migraine.Patients with this comorbidity often experience greater pain burden,more pronounced psychological dis-tress,and poorer quality of life.The underlying mechanisms may involve multiple factors,including the convergence of pain signals within the trigeminal system,peripheral and central sensitization,abnormal neuropeptide signaling involving calcitonin gene-related peptide,oral parafunctional behaviors,sleep disturbances,and psychological stress.The third edition of the International Classification of Headache Disorders(ICHD-3)classifies"headache attributed to temporoman-dibular disorder"as an entry for secondary headache diagnosis.Clinically,attention should be paid to differentiating mi-graine comorbid with TMD from TMD-related secondary headache.This review focuses on the epidemiological association,potential comorbid mechanisms,diagnostic differentiation,and oral clinical implications of migraine and TMD,aiming to provide a reference for the standardized identification and comprehensive management of affected patients.