Bongenhielm U, Robinson P P
Department of Oral and Maxillofacial Surgery, School of Clinical Dentistry, University of Sheffield, UK.
Pain. 1996 Oct;67(2-3):399-406. doi: 10.1016/0304-3959(96)03119-3.
The inferior alveolar nerve is a predominantly sensory branch of the trigeminal nerve which runs within a bony canal, and is frequently damaged in patients. A small proportion of these patients develop neuropathic pain, and this may result from neural activity generated at the injury site. To investigate this abnormality we have used electrophysiological techniques in an animal model to determine the level of spontaneous activity and mechanical sensitivity of myelinated fibres ending in a neuroma of the inferior alveolar nerve. In 20 anaesthetised adult male ferrets the left inferior alveolar nerve was ligated in the region of the third premolar tooth, cut distally, and recovery permitted for periods of 3-113 days prior to making single unit recordings from the nerve central to the injury. The proportion of units which were spontaneously active ranged from 0% to 26%, with discharge rates 0.3-12.9 Hz. Discharge in response to mechanical stimulation of the neuroma was found in 0-36% of the units. Both spontaneous activity and mechanical sensitivity were significantly higher after shorter recovery periods and the majority of the spontaneously active units was also mechanically sensitive. These data reveal that the inferior alveolar nerve responds to injury in a similar way to some other peripheral nerves, and the neural activity generated at the injury site may play a role in the development of dysaesthesia.
下牙槽神经是三叉神经的主要感觉分支,走行于骨管内,在患者中常受到损伤。这些患者中有一小部分会出现神经性疼痛,这可能是由损伤部位产生的神经活动引起的。为了研究这种异常情况,我们在动物模型中使用电生理技术来确定在下牙槽神经神经瘤中终末的有髓纤维的自发活动水平和机械敏感性。在20只麻醉的成年雄性雪貂中,将左下牙槽神经在第三前磨牙区域结扎,在远端切断,并在从损伤部位近端的神经进行单单位记录之前,允许恢复3 - 113天。自发活动的单位比例在0%至26%之间,放电频率为0.3 - 12.9 Hz。在0 - 36%的单位中发现了对神经瘤进行机械刺激时的放电。自发活动和机械敏感性在较短的恢复时间后均显著更高,并且大多数自发活动的单位也对机械敏感。这些数据表明,下牙槽神经对损伤的反应与其他一些周围神经相似,并且损伤部位产生的神经活动可能在感觉异常的发生中起作用。