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Difference between revisions of "Encrypted code: Hyperexcitability of the trigeminal system"
Encrypted code: Hyperexcitability of the trigeminal system (view source)
Revision as of 18:44, 27 April 2024
, 19 days ago→Final considerations
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<gallery mode="slideshow" widths="300" heights="170" perrow="1" caption="''Visual Cognitive gallery''"> | <gallery mode="slideshow" widths="300" heights="170" perrow="1" caption="''Visual Cognitive gallery''"> | ||
File:Bruxer Jaw jerk.jpeg|''<math>\gamma_2=</math> Jaw jerk: 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? 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 | File:Bruxer Jaw jerk.jpeg|''<math>\gamma_2=</math> Jaw jerk: 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? 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. 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? 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|'''<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 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|'''<math>\gamma_3=</math> Masseteric Silent Period:''' 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:Bruxer SP2.jpg|'''<math>\gamma_3=</math> Masseteric Silent Period:''' 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) | ||
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===Discussion=== | ===Discussion === | ||
The main aim of this study was to electrophysiologically document hyperexcitability of the trigeminal nervous system in a patient affected by pineal cavernoma with pronounced symptoms of OP and bruxism, and who was resistant to any pharmacological or odontological treatment. | The main aim of this study was to electrophysiologically document hyperexcitability of the trigeminal nervous system in a patient affected by pineal cavernoma with pronounced symptoms of OP and bruxism, and who was resistant to any pharmacological or odontological treatment. | ||