Prognostic factors, symptom evolution, and quality of life of persistent post-traumatic trigeminal neuropathy

Abstract Background: Post-traumatic trigeminal neuropathy (PTN) can have a substantial effect on patient well-being. However, the relation between the neuropathic symptoms and their effect on psychosocial functioning remains a matter of debate. The purpose of this study was to evaluate the association between objective and subjective assessments of neurosensory function in PTN and predict neurosensory outcome using baseline measurementsMethods: This prospective observational cohort study included patients diagnosed with PTN at the Department of Oral and Maxillofacial Surgery, University Hospital Leuven, Belgium, between April 2018 and May 2020. Standardized objective and subjective neurosensory examinations were recorded simultaneously on multiple occasions during the follow-up period. Correlation analyses and principal component analysis were conducted, and a prediction model of neurosensory recovery was developed. Results: Quality of life correlated significantly (P < 0.05) with percentage of affected dermatome (r = -0.35), the presence of brush stroke allodynia (r = -0.24), gain-of-function sensory phenotype (r = -0.41), Medical Research Council Scale (r = 0.36), and Sunderland classification (r = -0.21). Quality of life was not significantly correlated (P > 0.05) with directional discrimination, stimulus localization, two-point discrimination, or sensory loss-of-function. The prediction model showed a negative predictive value for neurosensory recovery after 6 months of 87%Conclusions: We found a strong correlation of subjective well-being with the presence of brush stroke allodynia, thermal and/or mechanical hyperesthesia, and the size of the neuropathic area. These results suggest that positive symptoms dominate the effect on affect. In patients reporting poor subjective well-being in the absence of positive symptoms or a large neuropathic area, additional attention towards psychosocial triggers might enhance treatment outcome. The prediction model could contribute to establishing realistic expectations about the likelihood of neurosensory recovery but remains to be validated in future studies.

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Author response for "Signs and symptoms, quality of life and psychosocial data in 1331 post-traumatic trigeminal neuropathy patients seen in two tertiary referral centres in two countries"

10.1111/joor.13058/v2/response1 ◽

2020 ◽

Author(s):

Fréderic Van der Cruyssen ◽

Frederik Peeters ◽

Thomas Gill ◽

Antoon De Laat ◽

Reinhilde Jacobs ◽

...

Keyword(s):

Quality Of Life ◽

Signs And Symptoms ◽

Author Response ◽

Tertiary Referral ◽

Trigeminal Neuropathy ◽

Post Traumatic

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Decision letter for "Signs and symptoms, quality of life and psychosocial data in 1331 post-traumatic trigeminal neuropathy patients seen in two tertiary referral centres in two countries"

10.1111/joor.13058/v2/decision1 ◽

2020 ◽

Keyword(s):

Quality Of Life ◽

Signs And Symptoms ◽

Tertiary Referral ◽

Trigeminal Neuropathy ◽

Post Traumatic

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Signs and symptoms, quality of life and psychosocial data in 1331 post‐traumatic trigeminal neuropathy patients seen in two tertiary referral centres in two countries

Journal of Oral Rehabilitation ◽

10.1111/joor.13058 ◽

2020 ◽

Vol 47 (10) ◽

pp. 1212-1221

Author(s):

Fréderic Van der Cruyssen ◽

Frederik Peeters ◽

Thomas Gill ◽

Antoon De Laat ◽

Reinhilde Jacobs ◽

...

Keyword(s):

Quality Of Life ◽

Signs And Symptoms ◽

Tertiary Referral ◽

Trigeminal Neuropathy ◽

Post Traumatic

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Post-traumatic trigeminal neuropathy: correlation between objective and subjective assessments and a prediction model for neurosensory recovery

The Journal of Headache and Pain ◽

10.1186/s10194-021-01261-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jeroen Meewis ◽

Tara Renton ◽

Reinhilde Jacobs ◽

Constantinus Politis ◽

Fréderic Van der Cruyssen

Keyword(s):

Quality Of Life ◽

Prediction Model ◽

Well Being ◽

Positive Symptoms ◽

Subjective Well Being ◽

Trigeminal Neuropathy ◽

Brush Stroke ◽

Subjective Assessments ◽

Post Traumatic

Abstract Background Post-traumatic trigeminal neuropathy (PTN) can have a substantial effect on patient well-being. However, the relation between the neuropathic symptoms and their effect on psychosocial functioning remains a matter of debate. The purpose of this study was to evaluate the association between objective and subjective assessments of neurosensory function in PTN and predict neurosensory outcome using baseline measurements. Methods This prospective observational cohort study included patients diagnosed with PTN at the Department of Oral and Maxillofacial Surgery, University Hospital Leuven, Belgium, between April 2018 and May 2020. Standardized objective and subjective neurosensory examinations were recorded simultaneously on multiple occasions during the follow-up period. Correlation analyses and principal component analysis were conducted, and a prediction model of neurosensory recovery was developed. Results Quality of life correlated significantly (P < 0.05) with percentage of affected dermatome (ρ = − 0.35), the presence of brush stroke allodynia (ρ = − 0.24), gain-of-function sensory phenotype (ρ = − 0.41), Medical Research Council Scale (ρ = 0.36), and Sunderland classification (ρ = − 0.21). Quality of life was not significantly correlated (P > 0.05) with directional discrimination, stimulus localization, two-point discrimination, or sensory loss-of-function. The prediction model showed a negative predictive value for neurosensory recovery after 6 months of 87%. Conclusions We found a strong correlation of subjective well-being with the presence of brush stroke allodynia, thermal and/or mechanical hyperesthesia, and the size of the neuropathic area. These results suggest that positive symptoms dominate the effect on affect. In patients reporting poor subjective well-being in the absence of positive symptoms or a large neuropathic area, additional attention towards psychosocial triggers might enhance treatment outcome. The prediction model could contribute to establishing realistic expectations about the likelihood of neurosensory recovery but remains to be validated in future studies.

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Results of osteopathic correction of patients with post-traumatic coccygodynia

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-1-2-19-27 ◽

2019 ◽

pp. 19-27

Author(s):

Yu. V. Antonova ◽

A. M. Iskandarov ◽

I. B. Mizonova

Keyword(s):

Quality Of Life ◽

Emotional State ◽

Pain Syndrome ◽

Control Group ◽

Life Questionnaire ◽

Treatment Area ◽

Diffi Cult ◽

Osteopathic Treatment ◽

Post Traumatic

Introduction.Coccygodynia is a multidisciplinary disease which is diffi cult to treat. It seriously limits the ability to work and signifi cantly affects the quality of life of patients. The study of somatic dysfunctions in patients with coccygodynia and the analysis of the results of osteopathic treatment of such patients makes it possible to justify the necessity of osteopathic correction of coccygodynia.Goal of the study— to determine the structure of the leading somatic dysfunctions in patients with coccygodynia and to study the effectiveness of osteopathic treatment of this pathology.Materials and methods.The study involved 44 patients from 25 to 65 years old, randomly divided into two groups. The main group of 24 people (20 women and 4 men) received osteopathic treatment, in accordance with the identifi ed leading somatic dysfunctions. Patients of the control group (16 women and 4 men) were treated locally with soft manual techniques (the treatment area was limited by the pelvic region). In order to assess the results of the treatment, we examined the intensity of the pain syndrome and the psycho-emotional state of patients. The severity of the pain syndrome was assessed in accordance with the visual analogue scale (VAS). The psycho-emotional state (with physical and mental components) was assessed with the help of the SF-36 quality of life questionnaire.Results.Somatic dysfunctions typical for patients with coccygodynia have been identifi ed. Osteopathic treatment has proven to be more effective in comparison with local manual therapy of coccygodynia both in early periods and in 3 months after the end of the treatment course.Conclusion.Osteopathic treatment of post-traumatic coccygodynia is effective, and can be recommended for treatment of such patients.

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