Objective： To quantitatively identify and grade trigeminal sensory functions after 3 major surgical procedures of trigeminal neuralgia using a newly developed quantitative sensory testing technique, current perceptio...Objective： To quantitatively identify and grade trigeminal sensory functions after 3 major surgical procedures of trigeminal neuralgia using a newly developed quantitative sensory testing technique, current perception threshold measurement （CPTM）. Methods： In the current study, there were 48 trigeminal neuralgia patients without history of prior surgical treatment. These patients received one of the following 3 surgical procedures, microvascular decompression （MVD）, peripheral nerve block with alcohol （PNB）, or percutaneous radiofrequency thermocoagulation （PRFT）. The quantitative sensory testing measurement, CPTM, and conventional qualitative sensory testing measurements were performed preoperatively and postoperatively to evaluate and grade the trigeminal sensory functions All 3 major cutaneous sensory fiber types, large myelinated fibers （A beta）, small myelinated fibers （A delta） and unmyelinated fibers（C） were allowed to quantitatively evaluate and grade by CPTM. The results of the measurements were statistically analyzed using a one-way analysis of variance （single factor）. Each subject was his/her own control for comparison of the preoperative to postoperative state on the asymptomatic and symptomatic sides. Subjects were tested 48 h preoperatively and 4 weeks postoperatively. Results： PNB with alcohol and PRFT caused significant sensory dysfunction postoperatively in every fiber type, indicating damage to all fibers. On the contrary, the sensory function in all 3 fiber types was unchanged after MVD management. Conclusion： Among the 3 major surgical procedures tested, only MVD preserves sensory function in trigeminal system. CPTM is of quantitative nature on the evaluation of sensory functions of nerve fibers展开更多
Objective: High frequency ultrasound combined with policy thermal perception testing (QTT) was used to analyze the characteristics of nerve damage in diabetic peripheral neuropathy (DPN), and then provided the basis f...Objective: High frequency ultrasound combined with policy thermal perception testing (QTT) was used to analyze the characteristics of nerve damage in diabetic peripheral neuropathy (DPN), and then provided the basis for the clinical prevention, diagnosis and treatment of DPN. Methods: A total of 110 DPN patients admitted to the hospital from December 2015 to May 2018 were selected, and the characteristics of nerve damage in diabetic peripheral neuropathy were analyzed by ultrasound and QTT. Results: In the results of QTT, the abnormal proportion of the CDT, WDT, CPT and HPT of the lower limbs in DPN's were all higher than the upper limbs;The difference of WDT and HPT in the age and course groups of patients in the upper limbs was statistically significant, the abnormal proportion of WDT and HPT in patients aged 60 years or above or with a course of 10 years or more were all above 45%, higher than those in other groups. The patients with larger mean amplitude of glycemic excursions (MAGE) were significantly higher than those with smaller MAGE, regardless of the abnormal proportion of WDT and HPT observed in upper limbs, lower limbs or upper and lower limbs;The results of ultrasonic measurement of nerve cross sectional area showed: the proportion of patients with ulnar nerve and median nerve abnormally thickened in the high age group (≥45 years) and the long course group (>10 years) was significantly higher than that in the low age group (<45 years) and the short course group (<10 years), the proportion of patients with larger MAGE with abnormal enlargement of median nerve was significantly higher than those with smaller MAGE. The thickening of ulnar nerve, median nerve and peroneal nerve was obvious in the patients of MAGE > 4 mmol/L. Conclusion: (1) The main nerve damage in DPN patients was thermal sensation damage, and the lower limb nerve was more vulnerable than the upper limb nerve. (2) The incidence of ulnar and median nerve damage was higher in patients aged 45 years and older or over 10 years of course. 展开更多
文摘Objective： To quantitatively identify and grade trigeminal sensory functions after 3 major surgical procedures of trigeminal neuralgia using a newly developed quantitative sensory testing technique, current perception threshold measurement （CPTM）. Methods： In the current study, there were 48 trigeminal neuralgia patients without history of prior surgical treatment. These patients received one of the following 3 surgical procedures, microvascular decompression （MVD）, peripheral nerve block with alcohol （PNB）, or percutaneous radiofrequency thermocoagulation （PRFT）. The quantitative sensory testing measurement, CPTM, and conventional qualitative sensory testing measurements were performed preoperatively and postoperatively to evaluate and grade the trigeminal sensory functions All 3 major cutaneous sensory fiber types, large myelinated fibers （A beta）, small myelinated fibers （A delta） and unmyelinated fibers（C） were allowed to quantitatively evaluate and grade by CPTM. The results of the measurements were statistically analyzed using a one-way analysis of variance （single factor）. Each subject was his/her own control for comparison of the preoperative to postoperative state on the asymptomatic and symptomatic sides. Subjects were tested 48 h preoperatively and 4 weeks postoperatively. Results： PNB with alcohol and PRFT caused significant sensory dysfunction postoperatively in every fiber type, indicating damage to all fibers. On the contrary, the sensory function in all 3 fiber types was unchanged after MVD management. Conclusion： Among the 3 major surgical procedures tested, only MVD preserves sensory function in trigeminal system. CPTM is of quantitative nature on the evaluation of sensory functions of nerve fibers
基金National Natural Science Foundation(81701891)Shiyan Municipal Leading Scientific Research Project in 2018(18Y63).
文摘Objective: High frequency ultrasound combined with policy thermal perception testing (QTT) was used to analyze the characteristics of nerve damage in diabetic peripheral neuropathy (DPN), and then provided the basis for the clinical prevention, diagnosis and treatment of DPN. Methods: A total of 110 DPN patients admitted to the hospital from December 2015 to May 2018 were selected, and the characteristics of nerve damage in diabetic peripheral neuropathy were analyzed by ultrasound and QTT. Results: In the results of QTT, the abnormal proportion of the CDT, WDT, CPT and HPT of the lower limbs in DPN's were all higher than the upper limbs;The difference of WDT and HPT in the age and course groups of patients in the upper limbs was statistically significant, the abnormal proportion of WDT and HPT in patients aged 60 years or above or with a course of 10 years or more were all above 45%, higher than those in other groups. The patients with larger mean amplitude of glycemic excursions (MAGE) were significantly higher than those with smaller MAGE, regardless of the abnormal proportion of WDT and HPT observed in upper limbs, lower limbs or upper and lower limbs;The results of ultrasonic measurement of nerve cross sectional area showed: the proportion of patients with ulnar nerve and median nerve abnormally thickened in the high age group (≥45 years) and the long course group (>10 years) was significantly higher than that in the low age group (<45 years) and the short course group (<10 years), the proportion of patients with larger MAGE with abnormal enlargement of median nerve was significantly higher than those with smaller MAGE. The thickening of ulnar nerve, median nerve and peroneal nerve was obvious in the patients of MAGE > 4 mmol/L. Conclusion: (1) The main nerve damage in DPN patients was thermal sensation damage, and the lower limb nerve was more vulnerable than the upper limb nerve. (2) The incidence of ulnar and median nerve damage was higher in patients aged 45 years and older or over 10 years of course.
