Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden.
Int J Oral Sci. 2013 Sep;5(3):150-4. doi: 10.1038/ijos.2013.42. Epub 2013 Jul 19.
There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury. Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma. The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders (WADs) with both a qualitative method and quantitative sensory testing (QST). Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women. Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits. Seven test sites in the facial skin (overlying each trigeminal branch bilaterally, and the midpoint of the chin) were examined. The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds. For the WAD patients, the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy, whereas QST systematically showed significantly higher detection thresholds (i.e., decreased sensitivity) for both cold and warm stimuli. For the individuals who were assessed as having increased sensitivity in the qualitative assessment, the QST displayed either normal or higher thresholds, i.e., decreased sensitivity. The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method. The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.
下颌和颈部区域之间存在密切的功能关系,有人认为,三叉神经感觉障碍可能会跟随挥鞭样损伤而出现。因此,对于暴露于这种创伤的患者,需要纳入可管理的常规操作来有效评估面部感觉能力,以便进行全面评估。本研究通过定性方法和定量感觉测试(QST)调查了慢性与挥鞭样损伤相关的障碍(WAD)患者的面部热阈值。将 10 名因挥鞭样损伤而出现疼痛和功能障碍的女性与 10 名年龄匹配的健康女性进行比较。通过定性椅旁测试和 QST(根据极限法)评估热探测阈值。对面部皮肤的 7 个测试部位(双侧三叉神经各分支上方,以及下巴中点)进行了检查。探测温暖和寒冷阈值被定义为 10 个个体阈值的平均值。与健康者相比,WAD 患者的定性评估显示出敏感性降低和敏感性增加,而 QST 则系统地显示出冷和热刺激的检测阈值明显升高(即敏感性降低)。对于在定性评估中被评估为敏感性增加的个体,QST 显示出正常或更高的阈值,即敏感性降低。结果表明,QST 比定性方法更能敏感地检测面部的热感觉障碍。患者的热敏感性受损证实了 WAD 相关疼痛引起的热探测能力改变的观点。