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At least 145 records · Page 8Linked to original sources

Referred pain after painful stimulation of the greater occipital nerve in humans: evidence of convergence of cervical afferences on trigeminal nuclei.

Cranial sensory innervation is supplied mainly by the trigeminal nerves and by the first cervical nerves. Excitatory and inhibitory interactions among those nerve roots may occur in a mechanism called nociceptive convergence, leading to loss of somato-sensory spatial specificity. Three volunteers in an experimental trial had sterile water injected over their greater occipital nerve on one side of the neck. Pain intensity was evaluated 10, 30 and 120 s after the injection. Two of the patients reported intense pain. Trigeminal autonomic features, suggestive of parasympathetic activation, were seen associated with trigeminally distributed pain. These data add to and reinforce previous evidence of convergence of cervical afferents on the trigeminal sensory circuit.

Adult↗

Neglected conditions producing preauricular and referred pain.

Various theories regarding temporomandibular joint symptoms are reviewed. Two hundred and forty six patients suffering from head, neck, or facial pain, or masticatory dysfunction were studied. In 108 of these patients, the diagnosis of temporomandibular joint synovitis, lateral pterygoid muscle dysfunction, or tenomyositis of the masseter muscle was made. Examination procedures, diagnosis, frequency of occurrence, and initial treatment of these conditions are described.

Adolescent↗

Somato-somatic referred pain caused by suprasegmental spinal cord tumor.

Tactile stimulation of a coin-sized area in a T-2 dermatome consistently triggered a lancinating pain in the ipsilateral C-8 dermatome in a 38-year-old woman. The SEP and an MRI led to a diagnosis of a tumor at the left cervico-medullary junction, much higher than the clinically suspected level. Surgical exploration revealed an exophytic glioma, and the pain was abolished postoperatively. Ephaptic transmission at the tumor site was suspected as a pathophysiologic mechanism.

Adult↗

Referred pain.

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Face↗

Referred pain.

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Aged↗

Centralization phenomenon. Its usefulness in evaluating and treating referred pain.

In patients with low-back and radiating leg pain, a clinical phenomenon has been described known as "centralization," which occurs during a mechanical evaluation protocol described by McKenzie. Relocation of the most distal pain in a proximal or central direction characterizes the pain behavior when patients are assessed in this fashion. Centralization typically occurs rapidly and can be maintained. In a review of 87 such patients, centralization occurred in 76 (87%). Its occurrence during initial mechanical evaluation is a very accurate predictor of successful treatment outcome and reliably determines the appropriate direction of treatment exercise. Nonoccurrence of centralization accurately predicts poor treatment outcome and was a helpful early predictor of the need for surgical treatment.

Adult↗