title: Functional and sensory evaluation of patients with idiopathic trigeminal neuralgia: comparison with controls.
abstract: BACKGROUND
  Idiopathic trigeminal neuralgia (ITN) can be associated with orofacial and sensory comorbidities.
  
  
  OBJECTIVE
  To evaluate the masticatory functional and sensory characteristics of patients with ITN compared with controls.
  
  
  METHODS
  We enrolled 119 patients and 30 healthy controls. They were evaluated with a systematic protocol: clinical orofacial evaluation questionnaire; a systematic approach of the mandibular function and the investigation of musculoskeletal comorbidities by the research diagnostic criteria for temporomandibular disorders (RDC/TMD) and the Helkimo indexes; and quantitative sensory testing (corneal reflex and gustative, olfactory, thermal, mechanical and pain thresholds).
  
  
  RESULTS
  The study group had more loss of vertical dimension than the controls (p=0.011) and restriction of the maximum mouth opening (p=0.024); they had more pain on mandibular movements (p=0.001), limitation of mandibular function (p<0.001), masticatory discomfort (p<0.001) and myofascial pain (p=0.001). Occlusion Helkimo index was lower in controls than patients. The study group had high tactile (p=0.025), warm (p=0.020) and cold (p=0.003) thresholds.
  
  
  CONCLUSIONS
  ITN may cause severe mandibular limitations that can be associated with the pain episodes and with sensory abnormalities. These findings indicate the affection of small and large nerve fibers and support the neuropathic nature of ITN. Sensory alterations can be part of the natural history of ITN and can be associated with the previous treatments including medication. They cause a high impact in quality of life.
authors.affiliation: Neurology Department, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Michelle Cristina
authors.initials: MC
authors.lastname: Ichida
authors.affiliation: Neurology Department, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Luciana
authors.initials: L
authors.lastname: Alvarenga da Silva
authors.affiliation: Interdisciplinary Pain Center of Hospital das Clinicas, Neurology Department, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Dentistry Division, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: José Tadeu Tesseroli
authors.initials: JT
authors.lastname: de Siqueira
authors.affiliation: School of Arts, Science and Humanities, University of São Paulo, São Paulo, SP, Brazil. Electronic address: silviadowgan@hotmail.com.
authors.forename: Silvia R D T
authors.initials: SR
authors.lastname: de Siqueira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005157:Facial Pain / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*; D012684:Sensory Thresholds / Q000502:physiology*; D014110:Touch / Q000502:physiology*; D014277:Trigeminal Neuralgia / Q000175:diagnosis / Q000503:physiopathology*
keywords: Masticatory function; Orofacial pain; Quantitative sensory testing; TMD; Trigeminal neuralgia