Temporomandibular disorder presenting as chronic migraine; the diagnostic role of MRI and interdisciplinary evaluation: A clinical report.

Temporomandibular disorders can mimic migraines and delay appropriate care. A 40-year-old man with 18 months of refractory temporal headache and facial pain, initially treated as migraine, underwent imaging that revealed bilateral temporalis hypertrophy and temporomandibular joint degenerative changes. More specifically, an interdisciplinary assessment confirmed temporomandibular disorders. Multimodal management included occlusal adjustment with a nocturnal occlusal device, counseling to reduce parafunction, physical therapy, low-level laser therapy, and targeted botulinum toxin A. Symptoms improved substantially over the 6 months, and migraine medications were subsequently discontinued.