Abstract:Objective To evaluate the effect of current perception threshold (CPT) measurement on sensory quantification in patients with trigeminal neuralgia. Methods From January 2017 to October 2018, 26 patients with primary trigeminal neuralgia involving the mandibular branches were selected from the Inpatient Department of Neurology or Outpatient Department of Jiangxi Provincial People′s Hospital. All patients were routinely treated with nutritive nerve drugs. The CPT and the simplified McGill pain questionnaire (SF-MPQ) were measured before, 7 and 14 days after treatment, and the CPT and SF-MPQ pain score were compared to evaluate the application value of CPT in the sensory function of patients with trigeminal neuralgia before and after treatment. Results Before treatment, when stimulated by 5 and 250 Hz, CPT on the affected side was higher than that on the healthy side, with statistically significant differences (all P < 0.05); while when stimulated by 2000 Hz, CPT on both sides showed no statistically significant difference (P > 0.05). CPT at 7 and 14 days after treatment on the affected side decreased under 5 and 250 Hz stimulation compared with before treatment, and the differences were statistically significant (all P < 0.05), while CPT on the affected side at 7 and 14 days after treatment under 2000 Hz stimulation was not statistically significant compared with that before treatment (P > 0.05). The pain score of SF-MPQ at 7 and 14 days after treatment was lower than that before treatment, and the differences were statistically significant (all P < 0.05). Pearson correlation analysis showed that SF-MPQ pain score at 7 and 14 days after treatment was positively correlated with CPT under 5 Hz stimulation of the affected mandibular branches (r = 0.656, 0.418, 0.697, P < 0.05). Conclusion CPT can quantitatively detect the sensory function of patients with trigeminal neuralgia before and after treatment, and objectively evaluate the severity of the condition before and after treatment and the therapeutic effect.
[1] 祝惠民.内科学[M].3版.北京:人民卫生出版社,1998:461-446.
[2] Spatz AL,Zaktzewska JM,Kay EJ. Decision analysis of medical and surgical treatments for trigeminal neural6a:how patient evaluations of benefits and risks affect the utility of treatment decisions [J]. Pain,2007,131(3):302-310.
[3] 王维治.神经病学[M].北京:人民卫生出版社,2005:118.
[4] 赵英.疼痛的测量和评估方法[J].中国临床康复,2002,6(16):2347-2349,2352.
[5] Cruccu G,Finnerup NB,Jensen TS,et al. Trigeminal neuralgia:New classification and diagnostic grading for practice and research [J]. Neurology,2016,87(2):220-228.
[6] 杨惠婕,唐元章,倪家骧.CT引导下经皮三叉神经半月节射频热凝术治疗其他术式术后复发三叉神经痛的疗效及安全性分析[J].中国全科医学,2016,19(12):1383-1386.
[7] 戴艳芳,陈楠,李坤成.三维双回波磁共振动静脉成像技术诊断血管压迫性三叉神经痛[J].中国医学影像技术,2016,32(11):1649-1653.
[8] Yin H,Liu M,Zhu Y,et al. Reference values and influencing faclors analysis for current perception threshold testing based on study of 166 healthy Chinese [J]. Front Neurosci,2018,12:14. doi:10.3389/fnins.2018.00014
[9] 谢可越,黄冰,姚明.CT引导下经圆孔内与圆孔外口射频治疗三叉神经上颌支痛效果的比较[J].中华麻醉学杂志2018,38(4):431-434.
[10] 唐枫燕,李全民.电流感觉阈值测定在糖尿病周围神经病变早期诊断中的应用[J].北京医学,2013,35(2):124-125.
[11] Jääskeläinen SK,Teerijoki-Oksa T,Forssell H. Neurophysiologic and quantitative sensory testing in the diagnosis of trigeminal neuropathy and neuropathic pain [J]. Pain,2005,117(3):349-357.
[12] Teerijoki-Oksa T,Jääskeläinen S,Forssell K,et al. An evaluation of clinical and electrophysiologic tests in nerve injury diagnosis after mandibular sagittal split osteotomy [J]. Int J Oral Maxillofac Surg,2003,32(1):15-23.
[13] Teerijoki-Oksa T,Jääskel?äinen SK,Forssell K,et al. Recovery of nerve injury after mandibular sagittal split osteotomy. Diagnostic value of clinical and electrophysiologic tests in the follow-up[J]. Int J Oral Maxillofac Surg,2004,33(2):134-140.
[14] Doi D,Ota Y,Konishi H,et al. Evaluation of the neurotoxicity of paclitaxel and carboplatin by current perception threshold in ovarian cancer patients [J]. J Nippon Med Sch,2003,70(2):129-134.
[15] Technology review: the Neurometer Current Perception Threshold(CPT). AAEM Equipment and Computer Committee. American Association of Electrodiagnostic Medicine [J]. Muscle Nerve,1999,22(4):523-531.
[16] Lv SL,Fang C,Hu J,et al. Assessment of Peripheral Neuropathy Using Measurement of the Current Percep- tion Threshold with the Neurometer(R)in patients with type 1 diabetes mellitus [J]. Diabetes Res Clin Pract,2015, 109(1):130-134.
[17] 潘晓丽,叶红莲,冯雪梅.电流感觉阈值测试在2型糖尿病小纤维神经病变的早期诊断价值[J].中国神经免疫学和神经病学杂志,2016,23(6):398-402.
[18] Liao MF,Lee M,Hsieh MJ,et al. Evaluation of the pathophysiology of classical trigeminal neuralgia by blink reflex study and current perception threshold testing [J]. J Headache Pain,2010,11(3):241-246.
[19] Olney RK. Clincal trails for polyneuropathy:the role of nerve conduction studies,quantitative sensory testing,autonomic function testing [J]. J Clin Neurophysiol,1998, 15(2):129-137.
[20] 刘倩影,倪华栋,陈雅静.CT引导下三叉神经射频热凝手术感觉神经定量检测的疗效评价[J].中国疼痛医学杂志,2019,25(12):898-902.
[21] 张健,施恩标,丁培源,等.CT下经皮穿刺半月神经节射频热凝治疗原发性三叉神经痛的临床效果[J].中国医药导报,2018,15(20):112-115,128.
[22] 张洁,李伟敏,邢岩.原发性三叉神经痛神经纤维受损的研究[J].现代电生理学杂志,2017,24(1):15-17.
[23] 刘盼,张勇,罗唯师.简化的McGill疼痛问卷表在三叉神经痛手术疗效评估中的应用[J].中南医学科学杂志,2013,41(1):68-71.