Functional brain imaging of trigeminal neuralgia

Moisset, Xavier; Villain, Nicolas; Ducreux, D.; Serrié, Alain; Cunin, G.; Valade, Dominique; Calvino, Bernard; Bouhassira, Didier

doi:10.1016/j.ejpain.2010.06.006

Cited by 81 publications

(73 citation statements)

References 51 publications

(93 reference statements)

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“…Patients in a crisis should be kept calm because they can feel overwhelmed by the pain and its continuation, which can induce more attacks. 65 For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe…”

Section: What Are the Surgical Options?mentioning

confidence: 99%

Trigeminal neuralgia

Zakrzewska

Linskey

2014

BMJ

214

197

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Section: What Are the Surgical Options?mentioning

confidence: 99%

Trigeminal neuralgia

Zakrzewska

Linskey

2014

BMJ

214

197

View full text Add to dashboard Cite

“…Additionally, a functional brain imaging study in TN further indicated sensitization of the trigeminal system. 22 …”

Section: General Hyperalgesia Indicative Of Central Sensitizationmentioning

confidence: 99%

Quantitative sensory testing in classical trigeminal neuralgia—a blinded study in patients with and without concomitant persistent pain

Younis

Maarbjerg

Reimer

et al. 2016

Pain

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The diagnostic criteria of the third International Classification of Headache Disorders state that there should be no neurological deficits in patients with classical trigeminal neuralgia (TN) at clinical examination. However, studies demonstrating sensory abnormalities at bedside examination in TN patients have questioned this. Our aim was to examine whether TN patients without sensory abnormalities at neurological examination have sensory abnormalities at quantitative sensory testing (QST) and whether there were any QST differences between TN with and without concomitant persistent pain. Thirty-six TN patients were investigated with the standardized QST protocol by the German Research Network on Neuropathic Pain. The investigators were blinded to presence of concomitant persistent pain and symptomatic side. Based on comparison to the German Research Network on Neuropathic Pain controls, z scores were calculated to process frequency analyses and Z-profiles. We found increased mechanical detection threshold on the symptomatic side (47.2% vs 0%, P = 0.008), asymptomatic side (33.3% vs 0%, P = 0.011), and hand (36% vs 0%, P < 0.001) in TN compared with controls. The Z-profiles demonstrated increased mechanical detection threshold on the symptomatic side compared with the asymptomatic side (-2.980 vs -2.166, P = 0.040). Thermal and mechanical hyperalgesia was detected bilaterally in the face and the hand. Trigeminal neuralgia patients with concomitant persistent pain tended to have higher mean z score values compared to TN with purely paroxysmal pain indicative of decreased detection thresholds. Trigeminal neuralgia patients with no sensory abnormalities at neurological examination had generalized subclinical hypoesthesia, which was more pronounced on the symptomatic side, and thermal and mechanical hyperalgesia. This could indicate pain-induced hypoesthesia and sensitization induced by central mechanisms.

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“…Studies with deep brain stimulation of the hypothalamus give further evidence of the role of the hypothalamus in SUNCT [56]. Functional brain imaging of TN in 15 patients with second or third division trigeminal involvement showed increased activity in the spinal trigeminal nucleus, thalamus, primary and secondary somatosensory cortices, anterior cingulate cortex, insula, premotor/motor cortex, prefrontal areas, putamen, hippocampus and brainstem [57]. To date, functional neuroimaging studies in first division TN have not been completed.…”

Section: Brain Activation Patterns On Functional Imagingmentioning

confidence: 99%

Tic Versus TAC: Differentiating the Neuralgias (Trigeminal Neuralgia) from the Cephalalgias (SUNCT and SUNA)

VanderPluym

Richer

2014

Curr Pain Headache Rep

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Trigeminal neuralgia, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with autonomic symptoms (SUNA) are classified as distinct disorders in the International Classification of Headache Disorders 3 beta (ICHD-3 beta). SUNCT and SUNA are primary headache disorders included among the trigeminal autonomic cephalalgias. Trigeminal neuralgia is classified under painful cranial neuropathies and other facial pains. The classification criteria of these conditions overlap significantly which could lead to misdiagnosis. The reported overlap among these conditions has called into question whether they should be considered distinct entities or rather a continuum of the same disorder. This review explores the known overlap and how other features not included in the ICHD-3 beta criteria may better differentiate the "Tics" (trigeminal neuralgia) from the "TACs" (SUNCT and SUNA).

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Functional brain imaging of trigeminal neuralgia

Cited by 81 publications

References 51 publications

Trigeminal neuralgia

Trigeminal neuralgia

Quantitative sensory testing in classical trigeminal neuralgia—a blinded study in patients with and without concomitant persistent pain

Tic Versus TAC: Differentiating the Neuralgias (Trigeminal Neuralgia) from the Cephalalgias (SUNCT and SUNA)

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