Validation of diagnostic methods for traumatic sensory neuropathy and neuropathic pain
Corresponding Author
Tuija Teerijoki-Oksa PhD
Department of Oral and Maxillofacial Diseases, Turku University Hospital, Lemminkäisenkatu 2, 20520 Turku, Finland
Correspondence to: T. teerijoki-oksa; e-mail: [email protected]Search for more papers by this authorHeli Forssell PhD
Department of Oral and Maxillofacial surgery, Institute of Dentistry, University of Turku, Turku, Finland
Search for more papers by this authorSatu K. Jääskeläinen
Professor
Departments of Clinical Neurophysiology, University of Turku and Turku University Hospital, Turku, Finland
Search for more papers by this authorCorresponding Author
Tuija Teerijoki-Oksa PhD
Department of Oral and Maxillofacial Diseases, Turku University Hospital, Lemminkäisenkatu 2, 20520 Turku, Finland
Correspondence to: T. teerijoki-oksa; e-mail: [email protected]Search for more papers by this authorHeli Forssell PhD
Department of Oral and Maxillofacial surgery, Institute of Dentistry, University of Turku, Turku, Finland
Search for more papers by this authorSatu K. Jääskeläinen
Professor
Departments of Clinical Neurophysiology, University of Turku and Turku University Hospital, Turku, Finland
Search for more papers by this authorABSTRACT
Introduction: We evaluated diagnostic value of sensory tests during recovery from iatrogenic sensory neuropathy using intraoperatively verified nerve injury with subjective symptoms as gold standard. Methods: Inferior alveolar nerves were monitored neurophysiologically throughout mandibular osteotomy in 19 patients. Sensory disturbance was registered and sensation tested using clinical and quantitative sensory (QST) and neurophysiologic tests postoperatively at 1, 3, 6, and 12 months. Sensitivity, specificity, and predictive values were calculated for all tests. Results: The sensitivity of clinical tests was at best 37%, with 100% specificity, but they lost diagnostic value at chronic stages. Best diagnostic accuracy (highest combination of sensitivity and specificity) at different time points was achieved by combining neurophysiologic and thermal QST or tactile and thermal QST. The single most accurate test was sensory neurography. Conclusions: Neurography or combinations of neurophysiologic and quantitative tests enables most reliable early and late diagnosis. Clinical sensory examination is inadequate for accurate diagnosis. Muscle Nerve 59:342–347, 2019
Supporting Information
| Filename | Description |
|---|---|
| mus26400-sup-0001-FigureS1.tifTIFF image, 743 KB | Figure S1 Placement of the recording and stimulating electrodes for neurography of the inferior alveolar nerve. The tip of the recording needle electrodes lies near the mandibular branch of the trigeminal nerve at the oval foramen. The reference electrode is fixed to the skin overlying the zygomatic arch. The inferior alveolar nerve is depicted with broken contour lines within the mandibular canal. Electrical stimuli were given at the mental foramen via a small bipolar surface electrode. |
| mus26400-sup-0002-TableS1.docxWord 2007 document , 18.4 KB | Table S1 Sensory tests, testing instruments and paradigms, and their reference limits according to laboratory specific reference values. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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