title: The trigemino-cervical reflex in patients with trigeminal neuralgia.
abstract: OBJECTIVE
  To investigate the central trigeminal system in idiopathic trigeminal neuralgia (TN).
  
  
  METHODS
  Short latency responses can be recorded in sternocleidomastoid (SCM) muscles after stimulation of the trigeminal nerve (trigemino-cervical reflex). This brainstem reflex was investigated in 40 healthy subjects and in 17 patients suffering from idiopathic TN before and after therapy for 2 months with carbamazepin.
  
  
  RESULTS
  Before therapy, six patients presented abnormalities of SCM responses on the painful side, six patients with bilateral abnormalities, and five patients with normal responses. A significant variation in the responses after therapy was found only in the patients with unilateral abnormalities: these patients and the patients with normal reflexes before therapy also had a good response to the therapy with significant pain relief.
  
  
  CONCLUSIONS
  Our findings suggest that the trigemino-cervical reflex could be useful in the clinical assessment of TN prior to instituting non-surgical treatment. The bilateral location of the abnormalities in some patients seems to point to a centrally located dysfunction; therefore, this study supports the idea that mechanisms in the central nervous system may play an important role in the pathophysiology of trigeminal neuralgic pain.
authors.affiliation: Department of Neurology, F.Tappeiner' Hospital, Via Rossini, 5, 39012 Merano, Italy. raffaele.nardone@asbmeran-o.it
authors.forename: Raffaele
authors.initials: R
authors.lastname: Nardone
authors.forename: Massimo F
authors.initials: MF
authors.lastname: Matullo
authors.forename: Frediano
authors.initials: F
authors.lastname: Tezzon
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D004558:Electric Stimulation / Q000379:methods; D004576:Electromyography / Q000379:methods; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D009334:Neck Muscles / Q000187:drug effects / Q000294:innervation / Q000503:physiopathology*; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D012018:Reflex / Q000187:drug effects / Q000502:physiology* / Q000528:radiation effects; D020433:Trigeminal Nerve Diseases / Q000503:physiopathology*; D014277:Trigeminal Neuralgia / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine