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Comments on the paper of Hampf et al. (Pain, 40 (1990) 241–248)
129
Pain, 43 (1990) 129 Elsevier
PAIN 01663
Letters to the Editor Comments on the paper of Hampf et al. (Pain, 40 (1990) 241-248) Pa010 Procacci Pain Cenrer, University of Florence, Viale G.B. Morgagni, 50134 Florence (Italy) (Accepted
Dear Editor, I have read with interest the paper of Hampf, Bowsher, Wells and Miles on sensory and autonomic measurements in trigeminal neuralgia, published in Pain, 40 (1990) 241-248. There are a number of points to be discussed. (1) From a taxonomical point of view, I think it is better to avoid the term ‘atypical facial pain,’ as the parallel term ‘atypical chest pain.’ I know that these locutions are largely used, but an atypical pain presupposes a typical pain and there is no reason to consider tic douloureux and angina pectoris the typical pain respectively of head and chest. It is better to classify the pain according to the origin and to the clinical features. (2) Tactile threshold was measured with Von Frey’s filaments (hairs); it would be opportune to measure pin-prick threshold with Von Frey’s stinging bristles, in order to have a parallel method.
03043959/90/$03.50
6 1990 Elsevier Science Publishers
15 May 1990)
(3) In the tic douloureux we have found not only the cutaneous trigger spots activated by low intensity mechanical stimulation, but also trigger points activated by pressure, especially in the gingival fomix. So it seems that the spectre of fibres activated cannot be only in the range AP but also in AS and possibly in unmyehnated fibres. We have no experimental findings proving which kinds of fibres are activated. As a matter of fact, some of the attacks are triggered by chewing. (4) I think that such a careful study on sensation must be performed also after Jannetta’s operation as in many cases of tic douloureux a vascular compression is the real cause of pain (see Loeser, J.D., Tic douloureux and atypical face pain. In: P.D. Wall and R. Melzack (Eds.), Textbook of Pain, 2nd edn., Churchill Livingstone, Edinburgh, 1989, pp. 535-543).
B.V. (Biomedical
Division)
Pain, 43 (1990) 129 Elsevier
PAIN 01663
Letters to the Editor Comments on the paper of Hampf et al. (Pain, 40 (1990) 241-248) Pa010 Procacci Pain Cenrer, University of Florence, Viale G.B. Morgagni, 50134 Florence (Italy) (Accepted
Dear Editor, I have read with interest the paper of Hampf, Bowsher, Wells and Miles on sensory and autonomic measurements in trigeminal neuralgia, published in Pain, 40 (1990) 241-248. There are a number of points to be discussed. (1) From a taxonomical point of view, I think it is better to avoid the term ‘atypical facial pain,’ as the parallel term ‘atypical chest pain.’ I know that these locutions are largely used, but an atypical pain presupposes a typical pain and there is no reason to consider tic douloureux and angina pectoris the typical pain respectively of head and chest. It is better to classify the pain according to the origin and to the clinical features. (2) Tactile threshold was measured with Von Frey’s filaments (hairs); it would be opportune to measure pin-prick threshold with Von Frey’s stinging bristles, in order to have a parallel method.
03043959/90/$03.50
6 1990 Elsevier Science Publishers
15 May 1990)
(3) In the tic douloureux we have found not only the cutaneous trigger spots activated by low intensity mechanical stimulation, but also trigger points activated by pressure, especially in the gingival fomix. So it seems that the spectre of fibres activated cannot be only in the range AP but also in AS and possibly in unmyehnated fibres. We have no experimental findings proving which kinds of fibres are activated. As a matter of fact, some of the attacks are triggered by chewing. (4) I think that such a careful study on sensation must be performed also after Jannetta’s operation as in many cases of tic douloureux a vascular compression is the real cause of pain (see Loeser, J.D., Tic douloureux and atypical face pain. In: P.D. Wall and R. Melzack (Eds.), Textbook of Pain, 2nd edn., Churchill Livingstone, Edinburgh, 1989, pp. 535-543).
B.V. (Biomedical
Division)