Evaluation of the pathophysiology of classical trigeminal neuralgia by blink reflex study and current perception threshold testingReport as inadecuate




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The Journal of Headache and Pain

, Volume 11, Issue 3, pp 241–246

First Online: 26 February 2010Received: 30 November 2009Accepted: 02 February 2010

Abstract

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.

KeywordsCurrent perception threshold Classical trigeminal neuralgia Unmyelinated fiber Neuropathic pain M. F. Liao and M. Lee contributed equally to the study.

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Author: Ming Feng Liao - Meng Lee - Mei Jen Hsieh - Mei Yun Cheng - Jiann Der Lee - Hsu Huei Weng - Long Sun Ro

Source: https://link.springer.com/







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