Trigeminal Disorders Research Articles

Evaluation of children and adults with post-COVID-19 persistent smell, taste and trigeminal chemosensory disorders: A hospital based study

Smell disorders are the most frequent persistent coronavirus disease 2019 (COVID-19) complications.To describe the patterns and characteristics of persistent smell and taste disorders in Egyptian patients.Assessment was done to 185 patients (adults = 150, age: 31.41 ± 8.63 years; children = 35; age: 15.66 ± 1.63 years). Otolaryngology and neuropsychiatric evaluations were done. Measurements included: A clinical questionnaire (for smell and taste); sniffin' odor, taste and flavor identification tests and the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS).Duration of disorders was 11.53 ± 3.97 ms (6-24 ms). Parosmia (n = 119; 64.32%) was developed months after anosmia (3.05 ± 1.87 ms). Objective testing showed anosmia in all, ageusia and flavor loss in 20% (n = 37) and loss of nasal and oral trigeminal sensations in 18% (n = 33) and 20% (n = 37), respectively. Patients had low scoring of sQOD-NS (11.41 ± 3.66). There were no specific differences in other demographics and clinical variables which could distinguish post-COVID-19 smell and taste disorders in children from adults.The course of small and taste disorders are supportive of the nasal and oral neuronal compromises. Post-COVID-19 taste and trigeminal disorders were less frequent compared to smell disorders. Post-COVID-19 flavor disorders were solely dependent on taste and not smell disorders. There were no demographics, clinical variables at onset or specific profile of these disorders in children compared to adults.

Smell, taste and trigeminal disorders in a 65\u2010year\u2010old population

BackgroundSmell, taste and trigeminal disorders likely have a substantial impact on human daily life. However, data regarding the prevalence of these disorders in Norway are scarce. The aim of this study was to investigate the prevalence of smell, taste, trigeminal disorders and associated factors in a 65-year-old population in Oslo, Norway.MethodsA random sample of 223 individuals (123 men, 100 women) participated in the study. Medical history was obtained, and unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were collected to determine salivary secretion rates. Sniffin`n Sticks and Taste Strips (Burghart Messtechnik GmbH, Wedel, Germany) were used for quantitative testing of olfactory and gustatory function. In addition, the participants’ self-reported perceptions of smell and taste, and burning mouth sensation were investigated.Results The results showed that 34 % of the participants had reduced smell (28 % hyposmia and 6 % anosmia) and 28 % had reduced taste perception (21 % hypogeusia and 7 % ageusia). 13 % of the partcipants had a combination of smell and taste disorders. Dysgeusia was reported by 5 % and burning mouth sensation (syndrome) by 3 % of the participants. Hyposmia, hypogeusia and ageusia were significantly more prevalent among men. Significant associations were found between taste disorders and previous history of cerebral hemorrhage and heart attack, and between burning mouth sensation and gastrointestinal disorders. Disturbances in olfactory, gustatory and trigeminal function were significantly related to medication use. Ageusia and burning mouth sensation were significantly more prevalent among smokers. Except from higher prevalence of ageusia among participants with hyposalivation with respect to SWS, no significant associations were found between salivary secretion rate and chemosensory or trigeminal disorders in the present study.ConclusionsThe present study revealed that one-third of 65-year-old individuals had impaired smell and more than one-fourth had impaired taste function. The prevalence of dysgeusia and burning mouth sensation was very low. Reduced smell and taste perception were more common among men than women. Furthermore, some diseases and medications were associated with chemosensory and trigeminal disorders. Ageusia was associated with SWS hyposalivation.

Complications in orthognathic surgery: A retrospective study of 5025 cases

Orthognathic surgery is a safe procedure with increasing indications during the past few decades. However, complications in exceptional situations can be serious and even lethal. In this article, we analysed the complications of orthognathic surgery with the aim to recognize and treat them appropriately. In all, 5025 cases of orthognathic surgery have been performed over a 25-year period. All the complications except trigeminal disorders, temporo-mandibular joint disorders, dental traumas, and bad splits were recorded with their corresponding management. In all, 73 complications were found including vascular complications, ophthalmic, infections, pseudarthrosis, and cranial base fractures. Complications in orthognathic surgery are rare. While many are manageable, some could have adverse outcomes. Each complication has its own treatment. Prevention can be achieved with perfect surgical techniques. However, some complications cannot be avoided even with skilled surgeons.

Association of Polymorphic Variants of Brain-Derived Neurotrophic Factor Gene (Bdnf Rs6265) and Glutamate Transporter Gene of the Second Type (Slc1a2 Rs4354668) with the Course of Multiple Sclerosis in Patients Living in Tomsk Region

Background: Multiple sclerosis (MS) is an autoimmune disease of the central nervous system that affects people of working age and ultimately leads to disability. This disease is of polygenic origin. The role of factors related to the pathogenesis of the disease and affecting both neuroinflammation and remyelination is studied. Aims: Our goal was to investigate the association of single nucleotide polymorphisms BDNF rs6265 and SLC1A2 rs4354668 with the risk of occurrence, clinical manifestations and the course of MS.Materials and methods: The study included 302 patients with MS, 268 healthy volunteers were enrolled in a control group. The obtained blood was used for DNA extraction by standard phenol-chloroform method. The identification of allelic variants of genes SLC1A2 (rs4354668) and BDNF (rs6265) was performed by polymerase chain reaction.Results: When comparing the frequencies of genotypes and alleles of polymorphic variants of BDNF and SLC1A2 genes between the groups of MS patients and the control group, no statistically significant differences were revealed. Comparison of genotype and allele frequencies of patients depending on sex, age of onset of the disease also did not reveal statistically significant differences. The study of the association of polymorphic variant of the gene BDNF (rs6265) with clinical manifestations of the disease revealed the association of genotype CC with oculomotor and trigeminal disorders at the onset of the disease (F=7, p=0.017). The study of the polymorphic variant rs4354668 of the glutamate transporter gene SLC1A2 revealed the association of allele G with an earlier (within 5 years from the moment of debut) transition of the disease to the stage of secondary progression, despite the therapy with DMT (χ2=5.940; p=0.010; OR 1.58; 95% CI 1.09−2.29). Homozygous genotype of TT (χ2=6.393; p=0.041; OR 0.50; 95% CI 0.28−0.88) and allele T (χ2=5.940; p=0.010; OR 0.63; 95% CI 0.44−0.92) of the polymorphism rs4354668 of the glutamate transporter gene SLC1A2 are significantly more common in the group of patients with late transition (15 years or more from the moment of debut) to the secondary progressive course.Conclusions: In our study we revealed the relationship of the studied polymorphic variants of genes with clinical signs at the onset of the disease and with the clinical manifestations of MS in patients living in the Tomsk region.

Peripheral Serotonin Enhances Orofacial Nocifensive Behavior in Female Rats at Lower Doses During Proestrus

Trigeminal pain, such as migraine and temporomandibular joint disorder pain, disproportionately affects women, however the mechanism underlying this dimorphic prevalence is unclear. One pain mechanism that may be modulated by gonadal hormones is the ability of the neurotransmitter serotonin (5HT) to lower pain thresholds. 5HT is a pronociceptive mediator in the periphery where it is stored and released by platelets and immune cells (e.g. mast cells, T‐cells, dendritic cells). The pronociceptive role of 5HT is well‐known in males, however 5HT may be under modulation by gonadal hormones in females. We recently reported that 5HT, injected into the hind paw, evoked greater, longer‐lasting pain behaviors in female rats during proestrus and estrus (dramatic fluctuations in hormones) compared to females in diestrus (steady low hormones), males, and ovariectomized (OVX) females. Further, when injected into the vibrissal pad, 5HT only evoked orofacial pain behaviors in females in proestrus and estrus. As 5HT receptors are colocalized with the transient receptor potential vanilloid 1 ion channel (TRPV1), a cation channel activated by capsaicin that initiates pain signaling, it is possible that 5HT differentially potentiates TRPV1 activity leading to our observed sex differences and estrous cycle effects. We hypothesized that 5HT potentiates capsaicin‐evoked orofacial nocifensive behaviors to a greater degree when hormones are in flux. Rats were acclimated and 24 hours later received a 50 μl injection of 1.5 μg 5HT + 1 μg capsaicin, 3 μg 5HT + capsaicin, or capsaicin only into the vibrissal pad (n=6–9 per group) and orofacial nocifensive behaviors were scored as number of forelimb swipes at the injection site in 6 min bouts over 30 min. We report that rats in proestrus exhibited significant nocifensive behaviors following injection of both the lower and higher doses of 5HT with capsaicin compared to capsaicin alone. Females in estrus and males exhibited significant nocifensive behaviors only following the higher 5HT dose with capsaicin. No significant effect of 5HT on capsaicin‐evoked pain behavior was observed in OVX females or females in diestrus. We also tested whether there were differences in 5HT content in the interstitial fluid of rodent vibrissal pads following 24 hours of inflammation. Rats received a left vibrissal pad injection of 50 μl complete Freund's adjuvant (CFA) and a right vibrissal pad injection of saline. After 24 hours, punch biopsies were collected and centrifuged to obtain interstitial fluid and 5HT content was quantified by ELISA. Males had significantly less serotonin content than cycling females in the saline‐injected vibrissal pads. When CFA elevated the 5HT content, a sex difference was no longer detected. Together our data indicate that serotonin may be enhancing TRPV1 activity at subthreshold doses when estrogen is high. Estrogen exacerbation of serotonergic pain in trigeminal sensory neurons combined with greater basal levels of serotonin in orofacial tissues may be one contributing factor to the greater prevalence of trigeminal disorders in women.Support or Funding InformationThis research is supported by NIH NIDCR R15DE025970 awarded to DLA. This study was also, in part, supported by TWU Research Enhancement Grants and a Chancellor's Research Fellowship.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Skin, fascias, and scars: symptoms and systemic connections.

Every element or cell in the human body produces substances that communicate and respond in an autocrine or paracrine mode, consequently affecting organs and structures that are seemingly far from each other. The same also applies to the skin. In fact, when the integrity of the skin has been altered, or when its healing process is disturbed, it becomes a source of symptoms that are not merely cutaneous. The skin is an organ, and similar to any other structure, it has different functions in addition to connections with the central and peripheral nervous system. This article examines pathological responses produced by scars, analyzing definitions and differences. At the same time, it considers the subcutaneous fascias, as this connective structure is altered when there is a discontinuous cutaneous surface. The consequence is an ample symptomatology, which is not limited to the body area where the scar is located, such as a postural or trigeminal disorder.

Triple Cysteine Module within M-Type K+Channels Mediates Reciprocal Channel Modulation by Nitric Oxide and Reactive Oxygen Species

We have identified a new signaling role for nitric oxide (NO) in neurons from the trigeminal ganglia (TG). We show that in rat sensory neurons from the TG the NO donor, S-nitroso-N-acetyl-dl-penicillamine, inhibited M-current. This inhibitory effect was blocked by NO scavenging, while inhibition of NO synthases increased M-current, suggesting that tonic NO levels inhibit M-current in TG neurons. Moreover NO increased neuronal excitability and calcitonin gene-related peptide (CGRP) release and these effects could be prevented by perturbing M-channel function. First, NO-induced depolarization was prevented by pre-application of the M-channel blocker XE991 and second, NO-induced increase in CGRP release was prevented by incubation with the M-channel opener retigabine. We investigated the mechanism of the effects of NO on M-channels and identified a site of action of NO to be the redox modulatory site at the triplet of cysteines within the cytosolic linker between transmembrane domains 2 and 3, which is also a site of oxidative modification of M-channels by reactive oxygen species (ROS). NO and oxidative modifications have opposing effects on M-current, suggesting that a tightly controlled local redox and NO environment will exert fine control over M-channel activity and thus neuronal excitability. Together our data have identified a dynamic redox sensor within neuronal M-channels, which mediates reciprocal regulation of channel activity by NO and ROS. This sensor may play an important role in mediating excitatory effects of NO in such trigeminal disorders as headache and migraine.

Sensory Action Potentials of the Maxillary Nerve: A Methodologic Study With Clinical Implications

Recently, recording of sensory nerve action potentials (SNAPs) of the inferior alveolar nerve (IAN) was described and is used as a diagnostic test of traumatic neuropathic trigeminal disorders. The technique is limited to IAN damage; therefore, we adapted the technique to the maxillary nerve, which is also frequently injured by either trauma or orthognathic surgery. Fourteen healthy volunteers participated in this methodologic study in which the infraorbital nerve (ION) was stimulated with 2 needle electrodes. The SNAPs were recorded from the maxillary nerve with a unipolar needle electrode close to the foramen rotundum. The mean latency of the SNAPs was 0.73 ms (95% CI, 0.55 to 0.85 ms) with a 0.08+/-0.09 ms interside difference. The mean baseline to peak amplitude was 31.3+/-7.0 microV (95% CI, 24.2 to 38.3 microV) with a 6.5+/-32.4 microV interside difference. Repeated tests within a session test demonstrated no significant differences in the latency data (ANOVA: P= .225) or amplitude data (ANOVA: P= .44). Stimulus-response curves indicated that the SNAPs saturated at 5.1+/-4.4 mA stimulus intensity. In 1 subject, stimulation of the mental nerve elicited SNAPs (latency: 1.6 ms; amplitude 38 microV) in accordance with published values. A local anesthetic block of the ION was associated with a distinct decay of the SNAP in 1 subject. We suggest that SNAPs of the maxillary nerve can be a valuable technique for a comprehensive examination of the trigeminal system.

A new method for evaluating trigeminal motor nerve conduction

AbstractThe electrodiagnosis test proposed by the authors can be used in the comparative bilateral evaluation of trigeminal motor nerve conduction. The mandibular division of this nerve is stimulated by applying a TENS device onto a pre-auricular point at the level of the semilunar mandibular notch. The responses in masseters and temporal muscles thus produced with masticatories in motion are recorded using an electromyograph set at 0–255 μ V.The response values characteristic of normal functionality average 20 μ V, while the corresponding values obtained from patients with trigeminal disorders, remained invariably below 10 μ V.

Mixed connective tissue disease. Progress of diagnosis and treatment. Treatment. 3. Clinic and treatment of special disease state. 2) Trigeminal disorder.

Mixed connective tissue disease. Progress of diagnosis and treatment. Treatment. 3. Clinic and treatment of special disease state. 2) Trigeminal disorder.