Case report
Carotidynia managed by surgical denervation of the carotid bulb

https://doi.org/10.1016/S0950-821X(05)80218-XGet rights and content

Carotidynia is a syndrome of pain in the neck and face accompanied by local tenderness of the carotid artery. The symptoms are often misdiagnosed due to similarities with more common syndromes involving the cervical region. Spontaneous remission is common; more severe cases generally respond to anti-inflammatory medication or prophylactic drugs used for migraine. A case of severe carotidynia, unassociated with migraine is reported. Failure to respond to medical therapy led to surgical denervation of the carotid bulb. The immediate relief of symptoms following surgery confirms earlier observations regarding the mechanism of the symptoms. In severe cases of carotidynia, surgical denervation of the carotid artery may be indicated if medical therapy has failed.

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    Since its initial description in 1927, the treatment of carotidynia has remained anecdotal, symptomatic, and without placebo-controlled trials. Treatment has varied widely from supportive care with rest, soft diet, aspirin, and reassurance2 to denervative surgery.28,29 After noting an apparent association with migraines, there were a number of reports of therapeutic responses to antimigraine medications such as propranolol, tricyclic antidepressants, ergotamine, and methysergide.30,31

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