Rasmussen P
University Clinic of Neurosurgery, Aarhus Municipal Hospital, Copenhagen, Denmark.
Acta Neurochir (Wien). 1991;108(3-4):100-9. doi: 10.1007/BF01418516.
In a prospective material of 1052 patients the precipitating factors, associated symptoms, psychological and neurological deficits have been examined. Mastication and talking are the most frequently occurring precipitating factors, 76% as regards Neuralgia, with typical starting difficulties. As regards Non-neuralgiform Pain 24%, with precipitation late in the masticatory process. There were trigger zones in 50% of the cases of Typical Trigeminal Neuralgia and in 9% of the patients with Non-neuralgiform Pain. In a series of cases the jaw joint is perceived as a trigger zone. Cold precipitates pain in 48%-39%. Other precipitating factors are much more rare--psychological stress in 15% of the patients with Non-neuralgiform Pain, however. "Vegetative" associated symptoms were relatively frequent, lacrimation occurred in 31% of the cases of Typical Trigeminal Neuralgia and in 20% of the cases of Non-neuralgiform Pain. Rhinorrhea and salivation were less frequent. In terms of figures migrainoid associated symptoms had no connection with vegetative associated symptoms or with pain in the eye. In 11% of the patients pain occurred most frequently during the night and in 20% the frequency of pain was the same day and night. About 1/3 of the patients with Neuralgia experienced seasonal variations. Tenderness of foramina is a symptom of no significance. Very few patients had primary sensory loss. No eye or ear symptoms have been found which may be referred to as the patho-anatomical basis of the pain. About 1/3 of the patients with Non-neuralgiform Pain had psychological symptoms whereas hardly any patients with Neuralgia had them. MMPI test performed on a small matched material showed no difference between Neuralgia and Non-neuralgiform Pain. In material B an examination has been made of the jaw joint arthrosis symptoms. A restriction of the diagnosis of arthrosis has had the effect that it must be recognized that patients with facial pain do not have the high frequency of jaw joint diseases previously assumed. As was also the case in a series of normal material previously published, between 1, 5 and 1, 3 of the patients with Neuralgia had jaw joint arthrosis which was due to old age. This study has not revealed any connection between previous diseases, the onset of pain, the character and course of the pain, the character of the attack, the localization of pain, precipitating factors, associated symptoms and symptoms of loss on the one hand and the patho-anatomical substratum on the other.
在一项对1052例患者的前瞻性研究中，对诱发因素、相关症状、心理和神经功能缺损进行了检查。咀嚼和说话是最常见的诱发因素，在神经痛患者中占76%，开始时通常有困难。在非神经痛样疼痛患者中占24%，在咀嚼过程后期诱发。50%的典型三叉神经痛病例和9%的非神经痛样疼痛患者有触发区。在一系列病例中，颌关节被视为触发区。寒冷诱发疼痛的比例为48% - 39%。其他诱发因素则罕见得多——然而，15%的非神经痛样疼痛患者有心理压力。“自主神经”相关症状相对常见，31%的典型三叉神经痛病例和20%的非神经痛样疼痛病例出现流泪。鼻溢和流涎较少见。就数据而言，类偏头痛相关症状与自主神经相关症状或眼部疼痛无关。11%的患者疼痛最常发生在夜间，20%的患者疼痛频率白天和夜间相同。约1/3的神经痛患者经历季节性变化。孔压痛是无意义的症状。极少数患者有原发性感觉丧失。未发现可作为疼痛病理解剖学基础的眼部或耳部症状。约1/3的非神经痛样疼痛患者有心理症状，而几乎没有神经痛患者有此类症状。对一小部分匹配样本进行的明尼苏达多相人格测验显示，神经痛和非神经痛样疼痛之间没有差异。在材料B中，对颌关节关节病症状进行了检查。对关节病诊断的限制产生了这样的效果，即必须认识到面部疼痛患者颌关节疾病的发生率并不像以前认为的那么高。正如之前发表的一系列正常样本中的情况一样，1.5%至1.3%的神经痛患者有因年龄增长导致的颌关节关节病。这项研究未揭示既往疾病、疼痛发作、疼痛特征和病程、发作特点、疼痛部位、诱发因素、相关症状和缺失症状与病理解剖学基础之间的任何联系。
