Carotidynia

Nosologic uncertainty about carotidynia has arisen, in part, because the syndrome was initially classified as an atypical facial neuralgia. More recently, carotidynia has been characterized as a recurring vascular neck pain, often accompanied by carotid tenderness and soft tissue swelling and sometimes by vascular headaches. We now report that drugs useful in the prophylaxis of migraine appear to be effective in carotidynia. Eight women (ages 39 to 77) with unilateral, episodic neck pain of 1 to 19 years' duration have been observed for periods ranging from 7 months to 6 years. All experienced marked relief in the intensity and frequency of their pain syndromes after the administration of methysergide, ergonovine maleate, propranolol, or nortriptyline. No patient had evidence of arteritis. The responsiveness of both migraine headaches and carotidynia to similar drugs suggests a common pathophysiologic mechanism.