Pain in trigeminal neuralgia: neurophysiology and measurement: a comprehensive review.
Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain within the distribution of one or more branches of the trigeminal nerve. It is the most frequent cranial neuralgia, the incidence being 1 per 1,000,00 persons per year. Pain attacks start abruptly and last several seconds but may persist 1 to 2 minutes. The attacks are initiated by non painful physical stimulation of specific areas (trigger points or zones) that are located ipsilateral to the pain. After each episode, there is usually a refractive period during which stimulation of the trigger zone will not induce the pain. According to the European Federation of Neurological Societies (EFNS) guidelines on neuropathic pain assessment and the American Academy of Neurology (AAN)-EFNS guidelines on TN management the neurophysiological recording of trigeminal reflexes represents the most useful and reliable test for the neurophysiological diagnosis of trigeminal pains. The present article discusses different techniques for investigation of the trigeminal system by which an accurate topographical diagnosis and profile of sensory fiber pathology can be determined. With the aid of neurophysiological recordings and quantitative sensory testing, it is possible to approach a mechanism-based classification of orofacial pain.
Private Practice.
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S
Kumar
Department of Oral and Maxillofacial Surgery and Oral Implantology, Institute of Technology and Sciences- Centre for Dental Studies and Research, Murad Nagar, Ghaziabad, India-201206.
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Rastogi
Department of Oral and Maxillofacial Surgery and Oral Implantology, Institute of Technology and Sciences- Centre for Dental Studies and Research, Murad Nagar, Ghaziabad, India-201206.
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S
Kumar
Department of Oral and Maxillofacial Surgery and Oral Implantology, Institute of Technology and Sciences- Centre for Dental Studies and Research, Murad Nagar, Ghaziabad, India-201206.
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Mahendra
Department of Periodontology, Institute of Dental Studies and Technologies, CCS University, Modinagar, Uttar Pradesh, India.
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Bansal
Department of Oral and Maxillofacial Surgery and Oral Implantology, Institute of Technology and Sciences- Centre for Dental Studies and Research, Murad Nagar, Ghaziabad, India-201206.
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Chandra
D006801:Humans; D009437:Neuralgia / Q000503:physiopathology; D009482:Neurophysiology; D014276:Trigeminal Nerve / Q000503:physiopathology; D014277:Trigeminal Neuralgia / Q000175:diagnosis* / Q000503:physiopathology*
neurophysiology; pain assessment; quantitative sensory testing; trigeminal neuralgia