Neurophysiological assessment of craniofacial pain

Galeotti, F.; Truini, Andrea; Cruccu, G.

doi:10.1007/s10194-006-0287-1

Cited by 17 publications

(10 citation statements)

References 65 publications

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“…Other advantages with laser stimulators include the possibility to emit a very brief pulse in the range from just a few ms to 200 ms, which allows the recording of time-locked electrophysiological responses like laser-evoked reflexes and brain potentials (164)(165)(166)(167)(168)(169)(170)(171)(172). Argon laser stimuli (k = 488-515 nm), CO 2 , copper vapour (k = 578 nm), neodymium-yttrium-aluminium garnet (Nd-YAG) (k = 1064 nm) and thulium-YAG (1800 nm) laser stimuli have up to now been used in the oro-facial region to test thermal sensations (172)(173)(174)(175)(176)(177). Reflection of the laser light is dependent on the wavelength, which should be taken into consideration if the thermal sensitivity of different tissue surfaces is to be compared (175).…”

Section: Thermal Stimulationmentioning

confidence: 99%

Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions - a taskforce report

Svensson

Baad‐Hansen

Pigg

et al. 2011

Journal of Oral Rehabilitation

174

203

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Summary The goals of an international taskforce on somatosensory testing established by the Special Interest Group of Oro-facial Pain (SIG-OFP) under the International Association for the Study of Pain (IASP) were to (i) review the literature concerning assessment of somatosensory function in the oro-facial region in terms of techniques and test performance, (ii) provide guidelines for comprehensive and screening examination procedures, and (iii) give recommendations for future development of somatosensory testing specifically in the oro-facial region. Numerous qualitative and quantitative psychophysical techniques have been proposed and used in the description of oro-facial somatosensory function. The selection of technique includes time considerations because the most reliable and accurate methods require multiple repetitions of stimuli. Multiple-stimulus modalities (mechanical, thermal, electrical, chemical) have been applied to study oro-facial somatosensory function. A battery of different test stimuli is needed to obtain comprehensive information about the functional integrity of the various types of afferent nerve fibres. Based on the available literature, the German Neuropathic Pain Network test battery appears suitable for the study of somatosensory function within the oro-facial area as it is based on a wide variety of both qualitative and quantitative assessments of all cutaneous somatosensory modalities. Furthermore, these protocols have been thoroughly described and tested on multiple sites including the facial skin and intra-oral mucosa. Standardisation of both comprehensive and screening examination techniques is likely to improve the diagnostic accuracy and facilitate the understanding of neural mechanisms and somatosensory changes in different oro-facial pain conditions and may help to guide management. assessments of all cutaneous somatosensory modalities. Furthermore, these protocols have been thoroughly described and tested on multiple sites including the facial skin and intraoral mucosa.Standardization of both comprehensive and screening examination techniques is likely to improve the diagnostic accuracy and facilitate the understanding of neural mechanisms and somatosensory changes in different orofacial pain conditions and may help to guide management.

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Section: Thermal Stimulationmentioning

confidence: 99%

Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions - a taskforce report

Svensson

Baad‐Hansen

Pigg

et al. 2011

Journal of Oral Rehabilitation

174

203

View full text Add to dashboard Cite

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“…Patients with classical trigeminal neuralgia usually have normal or only mildly abnormal trigeminal reflexes, whereas those with symptomatic trigeminal neuralgia typically have reflex abnormalities. 48 A recent study suggested that EP testing may distinguish symptomatic from classical trigeminal neuralgia with a sensitivity of 96% and a specificity of 93%, 49 although more clinical experience is needed. EP testing may also assist lesion localization.…”

Section: Imagingmentioning

confidence: 99%

“…For example, abnormal components of the blink reflex (R1 or R2) may help distinguish a peripheral from central lesion or help localize a lesion within the brainstem. 48 Other potentially useful tests are nerve conduction study of the mental nerve 50 and quantitative sensory testing of patients with sensory symptoms. 22 Sensitivity and specificity of these tests are unknown, as experience in their use is very limited.…”

Section: Imagingmentioning

confidence: 99%

Disorders of the Trigeminal System

Gonella¹,

Fischbein²,

So³

2009

Semin Neurol

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The management of patients with trigeminal system dysfunction requires an understanding of the system's complex anatomy, which extends from peripheral nerve endings, through the skull base, cavernous sinus (V1, V2 only), and trigeminal ganglion, to the intraaxial nuclei, tracts, and cerebral cortex. The differential diagnosis is broad. Seemingly minor facial sensory loss may indicate an underlying malignancy (as in numb-chin syndrome). Painful syndromes of the trigeminal nerve are numerous and require careful categorization. Understanding trigeminal system anatomy and the appropriate use of imaging and electrodiagnostics should aid in the diagnosis and treatment of these disorders.

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“…The diagnosis of trigeminal nerve damage generally involves the patients' clinical history, questionnaires, clinical examination, and psychophysical testing such as qualitative sensory testing (QualST) and quantitative sensory testing (QST), all of which require subjective responses from the patients [2]. Therefore, more objective investigative options may be valuable adjunct tools in the diagnostic repertoire to assess and confirm for definite neuropathic pain [3][4][5]. One such objective diagnostic test that can be used to attain the level of certainty to designate a diagnosis of definite neuropathic pain is the "nociceptive-specific" blink reflex (nBR) test [4].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and reliability of intraorally evoked “nociceptive-specific” blink reflexes

et al. 2019

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The "nociceptive-specific" blink reflex (nBR) evoked by extraoral stimulation has been used to assess trigeminal nociceptive processing in patients with trigeminal nerve damage regardless of the site of damage. This study aimed to: test the feasibility of nBR elicited by intraoral stimulation, compare intraoral and extraoral nBR, and assess the intrarater and interrater reliability of the intraoral nBR for the maxillary (V2) and mandibular (V3) branches of the trigeminal nerve. Materials and methods: In 17 healthy participants, nBR was elicited by stimulation of two extraoral and two intraoral sites by two operators and repeated intraorally by one operator. Main outcome variables were intraoral stimulus-evoked pain scores and nBR R2 responses at different stimulus intensities. Intraclass correlation coefficients (ICC) were used to assess reliability. Results: Dependent on the stimulus intensity, intraoral stimulation evoked R2 responses in up to 12/17 (70.6%) participants for V2 and up to 8/17 (47.1%) participants for V3. Pain scores (p<0.003) and R2 responses (p<0.004) increased with increasing intensities for V2, but not V3. The R2 responses were significantly smaller with intraoral stimulation compared to extraoral stimulation (p<0.014). Overall, ICCs were fair to excellent for V2 but poor for V3. Conclusion: Intraorally-evoked nBR was feasible in a subset of healthy participants and was less responsive than nBR with extraoral stimulation. The V2 nBR showed better reliability than V3.

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Neurophysiological assessment of craniofacial pain

Cited by 17 publications

References 65 publications

Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions - a taskforce report

Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions - a taskforce report

Disorders of the Trigeminal System

Feasibility and reliability of intraorally evoked “nociceptive-specific” blink reflexes

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