Trigeminal neuralgia and atypical facial pain: Use of the McGill pain questionnaire for discrimination and diagnosis

Abstract

Although trigeminal neuralgia and atypical facial pain can usually be distinguished on the basis of several well-established criteria, differential diagnosis is difficult in a small number of patients. The purpose of this study was to determine whether the McGill Pain Questionnaire (MPQ) is capable of discriminating between the two syndromes and might therefore serve as a diagnostic aid. The MPQ was administered to 74 patients in Pittsburgh and the data were analyzed statistically in Montreal. In an analysis of the data of 53 patients, 91% of the patients were correctly classified on the basis of 7 descriptors. To determine whether the key descriptors were able to predict the diagnosis of a second group, the discriminant function derived from the first analysis was applied to a new group of 21 patients. A correct prediction was made for 90% of the patients. The results indicate that, in difficult cases, the MPQ may be a useful tool to aid in differential diagnosis.

Microcirculatory changes identified by photoacoustic microscopy in patients with complex regional pain syndrome type I after stellate ganglion blocks

“…5 This inconsistency of outcome may be related to sympathetically maintained pain (SMP) and sympathetically independent pain (SIP). 41 SMP may be differentiated from SIP by a sympatholytic challenge provided by an intravenous injection of the α-adrenergic blocker phentolamine or sympathetic blocks. 42,43 Our preliminary data indicated only a subset of patients responded to SGB well, with significant pain relief and changes of PA signal and sO 2 , which supports the observation that "neuropathic pain is mediated or maintained by the sympathetic nervous system in only a subset of patients."…”

Lamotrigine Versus Pregabalin in the Management of Refractory Trigeminal Neuralgia: A Randomized Open Label Crossover Trial

“…This is an important finding that highlights the general inability of dentists and clinicians to accurately diagnose this condition in the early stages of progression. The McGill's pain questionnaire and its shorter format (SF-MPQ) have been shown to be effective in differentiating between pain conditions like TN or atypical facial pain [23]. Since this form addresses both the descriptive nature of pain and its intensity, we used the same during the screening period to formulate an unbiased diagnosis of TN.…”

Introduction: chronic pain studies of the lidocaine patch 5% using the neuropathic pain scale

“…Studies comparing the MPQ scales with measures of global pain intensity have supported the conclusions that the MPQ scores assess something more than pain intensity and that the MPQ scales show responsivity to treatment effects [16][17][18][19] . Research also indicates that responses to the MPQ may be used to differentiate between diagnostic groups in some situations [20][21][22] . Unfortunately, and despite evidence that supports the utility of MPQ scales in measuring responsivity to analgesic treatments, the scales tend to be less sensitive in detecting treatment effects when compared with singleitem pain intensity ratings [23][24][25] .…”