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March 21, 1980

The Orthopantomogram

Author Affiliations

San Antonio, Tex

JAMA. 1980;243(11):1131. doi:10.1001/jama.1980.03300370011006

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To the Editor.—  The article "Medical Uses of the Orthopantomogram" (242:1295, 1979) reminded me of an interesting case.

Report of a Case.—  A 14-year-old girl had a three-year history of pain in the right side of the face and a radiation toward the right temporomandibular joint and right temple. The pain, excruciating in nature, would occur after eating or drinking warm food or liquids and would last from a few seconds to five minutes. The girl was a cheerleader, and while jumping, she would feel that a tooth was moving up and down.The patient had been under the care of a general dentist who would make occasional diagnostic x-ray films. Because the patient had overcrowding of her teeth, she was seen by an orthodontist. A neurologist (friend of her father) prescribed carbamazepine (Tegretol), suspecting tic douloureux. A second orthodontist's opinion was sought, and he suggested referral to a neurosurgeon,