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Encrypted code: Hyperexcitability of the trigeminal system (view source)

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As we can see from the 'Visual Cognitive gallery', the neurological context is enriched by the contribution deriving from the decryption of the machine language through the <sub>rc</sub>MIR (<math>\gamma_4</math>) test to definitively close the diagnosis with the MR report (<math>\gamma_5</math>). The diagnostic model Masticationpedia not only supports the doctor in complex diagnoses but above all it is an element of implementation of our basic knowledge <math>(Kb)</math>. It will be useful to represent this cognitive interpretation by correlating it to the images of the assertions of the neurological context.
As we can see from the 'Visual Cognitive gallery', the neurological context is enriched by the contribution deriving from the decryption of the machine language through the <sub>rc</sub>MIR (<math>\gamma_4</math>) test to definitively close the diagnosis with the MR report (<math>\gamma_5</math>). The diagnostic model Masticationpedia not only supports the doctor in complex diagnoses but above all it is an element of implementation of our basic knowledge <math>(Kb)</math>. It will be useful to represent this cognitive interpretation by correlating it to the images of the assertions of the neurological context.


<gallery mode="slideshow" widths="300" heights="170" perrow="1">
<gallery mode="slideshow" widths="300" heights="170" perrow="1" caption="''Visual Cognitive gallery''">
File:Bruxer Jaw jerk.jpeg|'''Question 1:''' As a first step, the assertion that the specific phase highlights an anomaly, even if of minor importance, such as amplitude asymmetry, should always be considered, but the absolute value of the amplitudes on each side should also be noted at the same time. Note in the lower section of the window that the right masseter shows an amplitude of 5 mV while the left one of 8.50 mV. The question to ask is: What is the population mean jaw jerk amplitude? This question is of essential importance because it allows us to understand whether this asymmetry is primarily functional or organic and secondly to quantify its absolute response, but with respect to what?
File:Bruxer Jaw jerk.jpeg|'''Question 1:''' As a first step, the assertion that the specific phase highlights an anomaly, even if of minor importance, such as amplitude asymmetry, should always be considered, but the absolute value of the amplitudes on each side should also be noted at the same time. Note in the lower section of the window that the right masseter shows an amplitude of 5 mV while the left one of 8.50 mV. The question to ask is: What is the population mean jaw jerk amplitude? This question is of essential importance because it allows us to understand whether this asymmetry is primarily functional or organic and secondly to quantify its absolute response, but with respect to what?
File:Bruxer MEP.jpeg
File:Bruxer MEP.jpeg|'''<math>\gamma_1=</math> Trigeminale Root-MEPs:'''  To the motor evoked response of the trigeminal roots recorded on the masseter muscles called bRoot-MEPs.<ref>Frisardi G. The use of transcranial stimulation in the fabrication of an occlusal splint. J Prosthet Dent, 1992, DOI: 10.1016/0022-3913(92)90345-b</ref><ref>G. Frisardi 1, P. Ravazzani, G. Tognola, F Grandori. Electric versus magnetic transcranial stimulation of the trigeminal system in healthy subjects. Clinical applications in gnathology. J Oral Rehabil.1997 Dec;24(12):920-8. doi: 10.1046/j.1365-2842.1997.00577.x.</ref> This neurophysiological response indicates the anatomical component of the trigeminal motor system of the individual being examined and contextually the absolute amplitude value which, obviously, would correspond to the neuronal energy evoked by the depolarization of all the trigeminal motor fibres contained in the motor root. This very important datum determines the absolute value to which other reflections such as jaw jerk and lateral symmetry refer. Already from these first two questions, we can conclude that the average amplitude <math>\approxeq 30%</math>of the Root-MEPs we are faced with a datum far beyond the limit, namely  <math>\approxeq 79%</math>which represents a sort of hyper-excitability of the midbrain response.
File:Bruxer SP2.jpg
File:Bruxer SP2.jpg|'''Question 3:'''  Doubt could arise about being in a situation of degenerative and/or demyelinating neuropathy but the test of the electric masseter silent period annuls this hypothesis as both the latency and the duration of the first and second silent period (ES1 and ES2) are symmetrical. Also, the interposed activity of reactivation of the motor units which divides the two silent periods results in symmetry in the integral area between the sides. This data can only highlight hyperexcitability of the trigeminal system by coupling a second electrical stimulus following the first and evoking what has been described, i.e. the recovery cycle of the Inhibitory Masseter Reflex (<sub>rc</sub>RIM)
File:Recovery cycle.jpeg
File:Recovery cycle.jpeg|'''Question 4:''' The recovery cycle of the crRIM masseteric inhibitory reflex must be conceptually coupled to the exaggerated amplitude of the jaw jerk because it indicates a condition of hyperexcitability which certainly involves the mesencephalic nuclei with increased excitability of the  <math>\gamma</math> motoneurons and of the polysynaptic circuitry responsible for inhibition of the motor neuron of the masseter silent period. Take into account the value of the cognitive process of the neural network which has identified the decryption key of neural hyperexcitability in the <sub>cr</sub>RIM. Only with the jaw jerk exam, we would never reached the decryption until the patient's symptoms had worsened enough to require an MR but we all know that this eventuality could be delayed and fatal. Logically, the diagnosis following this process could have been made even 10 years earlier because a sort of attenuated hyperexcitability would certainly have already been present such as to make the physician suspicious.
File:Pineal cavernoma pre surgery 2.jpg
File:Pineal cavernoma pre surgery 2.jpg|'''Question 5:''' The conclusion of the process as already described indicates that a Cavernosa Pineal is very difficult to attack due to its anatomical position. The patient was referred to a specialist Centre of Neurosurgery in Verona by Prof. Albino Bricolo who succeeded in eliminating the vascular malformation through endoscopic surgery and giving our dear patient 'Bruxer' a dignified life without a dental bite plane.
</gallery><center>
</gallery><center></center>
{| class="wikitable"
{| class="wikitable"
|+
! colspan="2" |''Visual Cognitive gallery''
|-
| colspan="2" |As quoted somewhere of Masticationpedia also the sequence of the phases has its decrypting value, as will be deduced by describing the images and the cognitive contents resulting under each picture.
|-
|[[File:Bruxer_Jaw_jerk.jpeg|alt=|center|frameless]]<math>\gamma_2=</math> Jaw jerk
|'''Question 1:'''
As a first step, the assertion that the specific phase highlights an anomaly, even if of minor importance, such as amplitude asymmetry, should always be considered, but the absolute value of the amplitudes on each side should also be noted at the same time. Note in the lower section of the window that the right masseter shows an amplitude of 5 mV while the left one of 8.50 mV. The question to ask is: What is the population mean jaw jerk amplitude? This question is of essential importance because it allows us to understand whether this asymmetry is primarily functional or organic and secondly to quantify its absolute response, but with respect to what?
|-
|[[File:Bruxer_MEP.jpeg|alt=|center|frameless]]<math>\gamma_1=</math> Root-MEPs trigeminale
|'''Question 2:'''
To the motor evoked response of the trigeminal roots recorded on the masseter muscles called bRoot-MEPs.<ref>Frisardi G. The use of transcranial stimulation in the fabrication of an occlusal splint. J Prosthet Dent, 1992, DOI: 10.1016/0022-3913(92)90345-b</ref><ref>G. Frisardi 1, P. Ravazzani, G. Tognola, F Grandori. Electric versus magnetic transcranial stimulation of the trigeminal system in healthy subjects. Clinical applications in gnathology. J Oral Rehabil.1997 Dec;24(12):920-8. doi: 10.1046/j.1365-2842.1997.00577.x.</ref> This neurophysiological response indicates the anatomical component of the trigeminal motor system of the individual being examined and contextually the absolute amplitude value which, obviously, would correspond to the neuronal energy evoked by the depolarization of all the trigeminal motor fibres contained in the motor root. This very important datum determines the absolute value to which other reflections such as jaw jerk and lateral symmetry refer. Already from these first two questions, we can conclude that the average amplitude <math>\approxeq 30%</math> of the Root-MEPs we are faced with a datum far beyond the limit, namely <math>\approxeq 79%</math> which represents a sort of hyper-excitability of the midbrain response.
|-
|[[File:Bruxer_SP1.jpeg|alt=|center|frameless|260x260px]]<math>\gamma_3=</math> Periodo Silente Masseterino
|'''Question 3:'''
Doubt could arise about being in a situation of degenerative and/or demyelinating neuropathy but the test of the electric masseter silent period annuls this hypothesis as both the latency and the duration of the first and second silent period (ES1 and ES2) are symmetrical. Also, the interposed activity of reactivation of the motor units which divides the two silent periods results in symmetry in the integral area between the sides. This data can only highlight hyperexcitability of the trigeminal system by coupling a second electrical stimulus following the first and evoking what has been described, i.e. the recovery cycle of the Inhibitory Masseter Reflex (<sub>rc</sub>RIM)
|-
|[[File:Recovery_cycle.jpeg|alt=|center|frameless|270x270px]]<math>\gamma_4=</math> Ciclo di recupero del RIM
|'''Question 4:'''
The recovery cycle of the crRIM masseteric inhibitory reflex must be conceptually coupled to the exaggerated amplitude of the jaw jerk because it indicates a condition of hyperexcitability which certainly involves the mesencephalic nuclei with increased excitability of the <math>\gamma</math> motoneurons and of the polysynaptic circuitry responsible for inhibition of the motor neuron of the masseter silent period. Take into account the value of the cognitive process of the neural network which has identified the decryption key of neural hyperexcitability in the <sub>cr</sub>RIM. Only with the jaw jerk exam, we would never reached the decryption until the patient's symptoms had worsened enough to require an MR but we all know that this eventuality could be delayed and fatal. Logically, the diagnosis following this process could have been made even 10 years earlier because a sort of attenuated hyperexcitability would certainly have already been present such as to make the physician suspicious.
|-
|[[File:Pineal_cavernoma_pre_surgery_2.jpg|alt=|center|frameless|180x180px]]<math>\gamma_5=</math> Cavernoma Pineale
|'''Question 5:'''
The conclusion of the process as already described indicates that a Cavernosa Pineal is very difficult to attack due to its anatomical position. The patient was referred to a specialist Centre of Neurosurgery in Verona by Prof. Albino Bricolo who succeeded in eliminating the vascular malformation through endoscopic surgery and giving our dear patient 'Bruxer' a dignified life without a dental bite plane.
|-
|-
| colspan="2" |
| colspan="2" |
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|}
|}
</center>




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