Lingual Nerve Injury Flashcards
What is dysesthesia?
An abnormal and unpleasant sensation, either spontaneous or provoked
What is allodynia?
Pain in response to a normally non-noxious stimulus
What percent of lingual nerves lie above the lingual alveolar crest in the retromolar area?
14%
What is anesthesia dolorosa?
Pain in an area that is anesthetic
What is Tinel’s sign and what does it indicate?
A provocative test of regenerating nerve sprouts in which light percussion over a nerve elicits distal tingling.
-May indicate regeneration of small fiber recovery
OR
-Neuroma formation
How many levels are there for neurosensory testing?
3 levels
A, B, and C
What is level A in NST?
Directional and 2 point discrimination
What is level B in NST?
Contact detection
What is level C in NST?
Pain threshold and tolerance
What is normal 2 point detection for the LN?
6-7mm
What fibers does level A test?
A-alpha and A-beta fibers
What tools are used for testing level A
Use boley gauge or esthesiometer for 2 point
Use size 2-4 camel hair for directional movement
What fibers are tested in level B?
A-Beta fibers
What tools are used to test level B?
A series of filaments with increasing thickness/ stiffness for touch/pressure
What fibers are tested with level C testing?
A-delta, C, and unmyelinated fibers
What tools are used to test level C?
Pin prick
Thermal probe
Algometer
What is the term for Seddon Class 1?
Neuropraxia
What is the term for Seddon Class 2?
Axonotmesis
What is the term for Seddon Class 3?
Neurotmesis
What is the histological finding in neuropraxia?
No axonal damage, no demyelination, and no neuroma
What is the histological finding in axonotmesis?
Some axonal damage, demyelination, or neuroma formation
What is the histological finding in neurotmesis?
Severe axonal damage, nerve discontinuity, neuroma formation
What is the outcome from neuropraxia?
Rapid recovery (days to weeks)
What is the outcome for axonotmesis?
Loss of sensation, slow, incomplete recovery
Weeks to months
Microsurgery may help
What is the outcome for neurotmesis?
Loss of sensation, spontaneous recovery unlikely
Microsurgery may help
After what age is there a significant decrease in successful outcomes?
45
