Sensory functions in chronic neuralgia.

Eleven patients with sustained neuralgia, in most cases after traumatic nerve lesion, were subjected to quantitative sensory testing with thermal and non-noxious mechanical stimuli. Measurements were made in the pain area and at a homologous site on the contralateral normal side. All patients were hypoaesthetic with raised thresholds for warm and cold or touch, or both. Thermal pain thresholds were also raised in some patients but lowered in others indicating hypersensitivity of the nociceptor system or dysaesthesia for thermal input. In six patients single mechanical stimuli produced a painful response above the touch detection threshold. Reaction time measurements indicated that this painful response to suprathreshold mechanical pulses was measured by magnitude estimation as a function of stimulus amplitude. The results were fitted by power functions, as in normal skin, but with steeper slopes on the abnormal side. Suprathreshold hyperaesthesia (recruitment) may exist in the presence of normal threshold functioning.

[1]  U. Lindblom,et al.  Influence on touch, vibration and cutaneous pain of dorsal column stimulation in man , 1975, PAIN.

[2]  K. Horch,et al.  Specific regeneration of cutaneous fibers in the cat. , 1973, Journal of neurophysiology.

[3]  H. Shibasaki,et al.  Painful tonic seizure in multiple sclerosis. , 1974, Archives of neurology.

[4]  Georg v. Békésy,et al.  A New Audiometer , 1947 .

[5]  R. T. Verrillo,et al.  The effect of neural density and contactor surround on vibrotactile sensation magnitude , 1972 .

[6]  Georg v. Békésy,et al.  Neural Funneling along the Skin and between the Inner and Outer Hair Cells of the Cochlea , 1959 .

[7]  Y. Zotterman,et al.  THE DEVELOPMENT IN REGENERATING CUTANEOUS NERVES OF C-FIBRE RECEPTORS RESPONDING TO NOXIOUS HEATING OF THE SKIN , 1976 .

[8]  H. Head,et al.  THE AFFERENT NERVOUS SYSTEM FROM A NEW ASPECT , 1905 .

[9]  S. S. Stevens.  Tactile vibration: dynamics of sensory intensity. , 1959, Journal of experimental psychology.

[10]  S. Sunderland.  Pain mechanisma in causalgia. , 1976, Journal of neurology, neurosurgery, and psychiatry.

[11]  S. Sunderland.  Pain mechanisms in causalgia , 2022 .

[12]  H. Wolff,et al.  Pain Sensations and Reactions , 1953, Neurology.

[13]  A. Ward,et al.  Neuronal hyperactivity in experimental trigeminal deafferentation. , 1971, Journal of neurosurgery.

[14]  Jozef J. Zwislocki,et al.  Some Factors Affecting the Estimation of Loudness , 1962 .

[15]  R. T. Verrillo,et al.  Effects of root or nerve destruction on vibrotactile sensitivity in trigeminal neuralgia , 1977, Pain.

[16]  H. Fruhstorfer.  CONDUCTION IN THE AFFERENT THERMAL PATHWAYS OF MAN , 1976 .

[17]  H. Fruhstorfer,et al.  Method for quantitative estimation of thermal thresholds in patients. , 1976, Journal of neurology, neurosurgery, and psychiatry.

[18]  U. Lindblom.  Touch perception threshold in human glabrous skin in terms of displacement amplitude on stimulation with single mechanical pulses. , 1974, Brain research.

[19]  J. Zwislocki,et al.  On Some Factors Affecting the Estimation of Loudness , 1960 .

[20]  Jozef J. Zwislocki,et al.  A Power Function for Sensory Receptors , 1974 .

[21]  S. Weir Mitchell,et al.  Injuries to Nerves and Their Consequences , 1872, Buffalo Medical and Surgical Journal.

[22]  H. M. Davies,et al.  Experimental studies in the innervation of the skin , 1909, The Journal of physiology.

[23]  G. Békésy,et al.  Neural Volleys and the Similarity between Some Sensations Produced by Tones and by Skin Vibrations , 1957 .

[24]  D. Sinclair,et al.  An anatomical basis for alterations in quality of pain sensibility. , 1948, Journal of neurophysiology.

[25]  THE NERVOUS MECHANISM OF TOUCH AND PAIN , 1939 .

[26]  R. Melzack,et al.  Phantom limb pain: implications for treatment of pathologic pain. , 1971, Anesthesiology.

[27]  S. S. Stevens.  The direct estimation of sensory magnitudes-loudness. , 1956, The American journal of psychology.

[28]  P. Wall,et al.  Pain mechanisms: a new theory. , 1965, Science.

[29]  H. Newman.  NEURITIS, SENSORY NEURITIS, NEURALGIA , 1958 .

[30]  TACTILE INTENSITY FUNCTIONS IN PATIENTS WITH SUTURED PERIPHERAL NERVE , 1976 .

[31]  A. Fessard,et al.  Recent advances on the neurophysiological bases of pain sensation. , 1975, Acta neurobiologiae experimentalis.

[32]  P. Schilder.  Zur pathologischen physiologie der hautsinne , 1913 .

[33]  G. Wallin,et al.  PRELIMINARY OBSERVATIONS ON THE PATHOPHYSIOLOGY OF HYPERALGESIA IN THE CAUSALGIC PAIN SYNDROME , 1976 .

[34]  J. Goldberg,et al.  TEMPERATURE SENSITIVITY AND PAIN THRESHOLDS IN PATIENTS WITH PERIPHERAL NEUROPATHY , 1976 .

[35]  Patrick D. Wall,et al.  Ongoing activity in peripheral nerves: The physiology and pharmacology of impulses originating from a neuroma ☆ , 1974 .

[36]  D. Denny-Brown,et al.  The tract of Lissauer in relation to sensory transmission in the dorsal horn of spinal cord in the macaque monkey , 1973, The Journal of comparative neurology.

[37]  R. L. Richards.  Causalgia. A centennial review. , 1967, Archives of neurology.

[38]  C. S. Hallpike.  Sensori-Neural Deafness and Derangements of the Loudness Function: their Nature and Clinical Investigation , 1976 .