19. Pharmaco-resistant essential trigeminal neuralgia: Psychophysiological analysis of the effects of the percutaneous RF diathermocoagulation

S. Cusumano, P. Cisotto, P. Guerra, N. Birbaumer, A. Carteri

Research output: Contribution to journalArticle

Abstract

Diathermocoagulation has proved effective in pharmaco-resistant essential trigeminal neuralgia (PRETN). Our study firstly investigated which psychological pain assessment scales best describe the improvements occurring in such chronic pain condition and their relation, if any, with the modifications of some neurophysiological pontine reflexes. 19 patients were analysed. Neurophysiological tests: a) the R1, R2 and R3 responses of the blink reflex by electrical stimulation of the 1st trigeminal division, b) the silent periods of the masseter muscles by stimulation of the 2nd and 3rd trigeminal divisions, c) the blink reflex responses by auditory startle reaction. Psychological tests: the West Haven-Yale Multidimensional Pain Inventory (WHYMPI), the Pain-Related Control Scale (PRCS), the Pain-Related Self-Statements (PRSS), the McGill Pain Questionnaire (MGPQ) and the Visual Analogue Scale (VAS) tests. Recording sessions: - just before diathermocoagulation, - 1 week, - 1 month and - 6 months later. A complete remission of the painful syndrome occurred in 15 patients, a partial remission in 2 and a poor remission in 2. The PRCS "helplessness", the PRSS "active coping" and the WHYMPI "self-control" scales were selected by factor analysis within the 1st "psychological" factor. The auditory startle reaction and the blink R3 response were selected within the 2nd "neurophysiological" factor. It has emerged that the modifications of such neurophysiological variables are strictly related to each other and tend to be inversely related to the raised pain threshold in the affected side.

Original languageEnglish
Pages (from-to)231
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume18
Issue number4
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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