Proposal for a standardized protocol for the systematic orofacial examination of patients with Hereditary Sensory Radicular Neuropathy

Abstract

* Patients with HSRN may present with significant, silent dental disease. * A standard protocol is helpful when evaluating such patients. * If the opportunity arises, evaluation of pulp tissue may reveal an altered proportion of myelinated and unmyelinated nerve fibres. This may avoid the more estabilished sural nerve biopsy.

Somesthetic, gustatory, olfactory function and salivary flow in patients with neuropathic trigeminal pain

“…Our anterior results show that trigeminal somesthetic abnormalities can be evidenced in ITN, although discrete (Siqueira et al, 2006), similar to other findings in the same patients (Synai et al, 2003). In this controlled sample, we could observe that among trigeminal abnormalities, ITN had the most discrete findings and that only the pain thresholds were increased.…”

“…After the evaluation of salivary flow, all subjects underwent a standardized protocol of superficial facial perception, which was applied in distinct areas of the face (bilateral trigeminal branches in the following order); in the intraoral area, only pain thresholds were evaluated (superior and inferior arches: bilateral vestibular gingiva) (Siqueira et al , 2006):…”

The Expression of Nitric Oxide in the Gingival Tissue in Subjects with Periodontitis and Chronic Pain

“…Despite the important central mechanisms in chronic or persistent pain, peripheral components should be considered and remain targets of clinical care and research. The evaluation of neurotransmitters in the gingival tissue is a model of study that we have been using in order to analyze the peripheral tissue of patients with congenital insensitivity to pain (Siqueira et al, 2006). The gingival tissue sample provide the advantage of being easily removed, it involves a brief healing process, represents a fraction of the trigeminal nerve and enables the analysis of peripheral components of the trigeminal nervous system.…”

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“…There are several articles about this methodology in the literature and the use of QST is mainly in research, and there are systematized protocols for the orofacial region [2][3][4][5] . The importance in the neuropathic pain of this body area is crucial.…”