Evaluation of the pathophysiology of classical trigeminal neuralgia by blink reflex study and current perception threshold testing

The Journal of Headache and Pain

Original

Jiann Der Lee¹  Meng Lee¹  Mei Jen Hsieh²  Mei Yun Cheng³  Long Sun Ro³  Ming Feng Liao³  Hsu Huei Weng⁴ 

[1] Department of Neurology, Chiayi Branch, Chang Gung Memorial Hospital and College of Medicine, Chang-Gung University, Taipei, Taiwan;Department of Neurology, Kaohsiung Branch, Chang Gung Memorial Hospital and College of Medicine, Chang-Gung University, Taipei, Taiwan;Department of Neurology, Linkou Headquarters, Chang Gung Memorial Hospital and College of Medicine, Chang-Gung University, 199, Tung Hwa North Road, Taipei, Taiwan;Diagnostic Radiology, Chiayi Branch, Chang Gung Memorial Hospital and College of Medicine, Chang-Gung University, Taipei, Taiwan;

关键词: Current perception threshold;    Classical trigeminal neuralgia;    Unmyelinated fiber;    Neuropathic pain;   

DOI  :  10.1007/s10194-010-0198-z

 received in 2009-11-30, accepted in 2010-02-02,  发布年份 2010

来源: Springer

【 摘 要 】

We recruited 49 patients with classical trigeminal neuralgia (TN) according to the latest guidelines of the International Classification of Headache Disorders, and divided them into an acute (≤30 days onset; 13 patients) and a chronic (>30 days onset; 36 patients) group. We used blink reflex study and current perception threshold (CPT) testing to evaluate the painful facial areas and contralateral non-painful areas of patients with classical TN. CPT 5 Hz examinations, which correlate with unmyelinated fiber function, showed significantly decreased CPTs in the acute stage (11.62 ± 6.99 vs. 18.69 ± 9.66, P = 0.025), but significantly increased CPTs in the chronic stage (26.67 ± 18.65 vs. 19.69 ± 13.70, P = 0.010) on the painful side when compared with the contralateral non-painful side. However, CPTs at 250 Hz (Aδ) and 2000 Hz (Aβ) examinations did not show significant differences between the painful and non-painful sides. In contrast, only three (3/49) patients showed an abnormal trigeminal nerve stimulation on the ipsilateral painful side by blink reflex study. The findings suggest that classical TN is not a simple large-myelinated nerve fiber dysfunction but a more complex process with a main dysfunction of unmyelinated nerve fibers.

【 授权许可】

Unknown   
© Springer-Verlag 2010