不确定的牙痛:临床特征和神经血管压缩;一个回顾性案例比较研究
Kiyokazu Iwawaki1, Motoko Watanabe1, Yasuyuki Kimura1
1Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.
Frontiers in pain research (Lausanne, Switzerland)
|December 3, 2025
概括
从三角神经疼痛 (TN) 区分持久性异常性牙气膜疼痛 (PIDAP) 需要不仅仅是检查神经血管压缩 (NVC). 疼痛质量,灾难化和中央敏感性是这些非牙痛疾病的关键诊断因素.
科学领域:
- 神经学 神经学
- 疼痛医学 医学 疼痛医学
- 牙科 牙科 牙科 牙科
背景情况:
- 非odontogenic牙痛带来诊断挑战,特别是区分持久性异常性牙气囊疼痛 (PIDAP) 和三角神经疼痛 (TN).
- 在这些情况下,不典型的感觉和持续的面部疼痛使准确的诊断变得复杂.
研究的目的:
- 为了澄清未被诊断的持续性疼痛患者的临床特征.
- 确定区分PIDAP与TN的现实世界临床因素.
主要方法:
- 从340名未被诊断的持续性疼痛患者的临床数据的回顾性收集.
- 基于神经血管压缩 (NVC) 和PIDAP或TN的最终诊断,对149名单边症状患者的比较分析.
主要成果:
- 双边症状与更严重的疼痛和更高的疼痛灾难性相关 (p=0.022).
- 虽然NVC在56.4%的患者中存在,但它没有显著区分临床特征.
- TN患者表现出更强烈的"射击"和"刺伤"疼痛 (p≤0.006) 和更严重的NVC (p=0.033),而PIDAP患者在中央敏感性 (p<0.001) 和体症状尺度 (p=0.004) 上得分更高.
结论:
- 神经血管压缩 (NVC) 单独不足以区分PIDAP和TN.
- 评估疼痛质量,灾难化,中央敏感化和体质症状对于准确诊断至关重要.
- 除了这些因素之外,对神经血管疾病的详细评估有助于区分PIDAP和TN.
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