Svensson Peter, Baad-Hansen Lene, Thygesen Torben, Juhl Gitte I, Jensen Troels Staehelin
Department of Clinical Oral Physiology, Royal Dental College, University of Aarhus, Aarhus, Denmark.
J Orofac Pain. 2004 Fall;18(4):332-8.
This article provides a brief overview of the tools and methods that may be useful to assess neuropathic trigeminal pain. Pain is a complex multidimensional and biopsychosocial experience. While the assessment of neuropathic trigeminal pain is complex, there are several meaningful ways available for the systematic assessment of neuropathic pain and its effects and manifestations. The key to such an analysis is a standardized pain history and examination and a good knowledge of pain mechanisms. Patients can be asked to provide detailed information about their spontaneous pain (ie, stimulus-independent pain), eg, quality, intensity, localization, time course, and modifying factors. Stimulus-dependent pain components can be characterized with clinical examination procedures and quantitative psychophysical techniques such as application of mechanical, thermal, chemical, and electrical stimuli. The description of the stimulus-dependent pain is important to reveal the function of the somatosensory system and to map the extent of hyperalgesia, hyperesthesia and allodynia, because the normal relationship between stimulus intensity and perceived intensity is distorted in many neuropathic pain conditions. In addition to the psychophysical techniques, a number of laboratory tests for assessment of trigeminal pain have been developed and tested, although critical information on sensitivity, specificity, and predictive values is still scarce. There is also a need for common guidelines on classification, diagnostic procedures, and management. This will require concerted international, interdisciplinary action.
本文简要概述了可能有助于评估三叉神经病理性疼痛的工具和方法。疼痛是一种复杂的多维度生物心理社会体验。虽然三叉神经病理性疼痛的评估很复杂，但有几种有意义的方法可用于系统评估神经病理性疼痛及其影响和表现。这种分析的关键是标准化的疼痛病史和检查，以及对疼痛机制的充分了解。可以要求患者提供有关其自发痛（即非刺激依赖性疼痛）的详细信息，例如性质、强度、部位、病程和缓解因素。刺激依赖性疼痛成分可以通过临床检查程序和定量心理物理学技术来表征，如施加机械、热、化学和电刺激。刺激依赖性疼痛的描述对于揭示躯体感觉系统的功能以及描绘痛觉过敏、感觉异常和痛觉超敏的范围很重要，因为在许多神经病理性疼痛情况下，刺激强度与感知强度之间的正常关系会被扭曲。除了心理物理学技术外，已经开发并测试了一些用于评估三叉神经疼痛的实验室检查，尽管关于敏感性、特异性和预测值的关键信息仍然很少。还需要关于分类、诊断程序和管理的通用指南。这将需要国际上协调一致的跨学科行动。
