Migraine et névralgie du trijumeau sont deux douleurs céphaliques bien différentes, associées à des manifestations allodyniques. Reflétant une sensibilisation centrale, étudier l’allodynie permet de mieux comprendre les mécanismes impliqués dans ces douleurs.- Dans le cas de la migraine: La céphalée est susceptible d’induire par son intensité et sa répétition des modifications profondes du fonctionnement cérébral, conduisant à l’amplification à la fois temporelle (chronicité) et spatiale (allodynie et hyperalgésie extracéphalique) de l’information nociceptive. Les modifications sont durables puisque l’hyperalgésie extra-trigéminale est constante chez le migraineux notamment en période intercritique. Cet état «préallodynique» permanent pourrait être attribuable à une facilitation tonique descendante des informations nociceptives afférentes au niveau de la corne dorsale. L’allodynie qui se développe préférentiellement au cours des crises seraient davantage liée à une altération de l’inhibition descendante corrélée à la fréquence des crises. La mise en jeu des mécanismes inhibiteurs descendant semble être modulable. L’altération des CIDN chez les migraineux est améliorée lorsque des antalgiques/traitements de crise de migraine sont régulièrement consommés. Le sevrage en antalgiques améliore la fréquence des crises mais engendre une re-dégradation des CIDN. L’abus joue donc un rôle promoteur des crises soit via un effet périphérique au niveau des afférences primaires, soit au niveau cortical, mais en tout cas, pas via une altération de la modulation inhibitrice descendante issues des structures du tronc cérébral. - Dans le cas de la névralgie du trijumeau, l’allodynie a des caractéristiques différentes puisqu’elle est très localisée, paroxystique, mécanique et dynamique. Néanmoins la mise en évidence d’une allodynie à tous les modes diffuse au niveau céphalique fait évoque l’existence d’une sensibilisation centrale dans la névralgie du trijumeau. La corrélation qui existe entre abaissement des seuils et nombre de désafférentations d’origine dentaire,amène à envisager que les lésions répétées au niveau des fibres de type C, est à même d’induire des modifications plastiques au niveau de la corne dorsale du sous noyau caudal, permettant alors aux fibres myélinisées de gros calibres, d’accéder aux voies de la nociception, notamment les couches superficielles.Ce facteur serait prédisposant mais pas en lui même un facteur causal suffisant. Une compression nerveuse est plus souvent retrouvée du coté douloureux mais ne semble pas non plus à elle un facteur suffisant pour générer la douleur. La compression nerveuse pourrait contribuer à la pathologie soit via une aggravation de la déafférentation, notamment au niveau des fibres A, soit via un rôle générateur local de potentiels d’action au niveau de ces fibres de gros calibre, ce qui expliquerait qui plus est la disparition très rapide, parfois quasi immédiate de la douleur lorsque les patients subissent une micro-décompression vasculaire. / Migraine and trigeminal neuralgia are two separate cephalic pain characterized by allodynia. Allodynia is of intense interest because it is a way to explore mechanism of pain. Then our work helps to better understanding pathophysiology of these two pain cephalic diseases. -In migraine: During attacks, cutaneous allodynia can extend outside the head involving mosthly thermal modalities. In between attack migraine patients are also characterized by greater extracephalic temporal pain summation and hyperalgesia unrelative to headache frequency or medication intake. Extratrigeminal hyperalgesia and allodynia may be consequence of central sensitization of spinal dorsal horn neurol in relation to tonic descending facilitation of pain. Migraine patients have also impairment of DNIC but in opposite to pain facilitation, DNIC magnitude is changed by several conditions. Loss of DNIC may be driven by repetition of headache and could lead to allodynia extension during attacks. Medication overuse also improves migraine-induced DNIC impairment. Since improvement of DNIC is not able to offset central sensitization, pain facilitation and descending inhibitory input involve two separate and independent ways. Moreover medication overuse may promote the increasing of headache frequency acting on others brain structures than descending pain inhibition. - In trigeminal neuralgia: our current findings promote the possibility that small fibers lesions due to dental deafferentation are predisposing factors for classical trigeminal neuralgia. Patients with CTN have bilateral trigeminal pain hypersensitivity over the trigeminal region, suggesting a central sensitization process. The relationship between pain thresholds and number of dental deafferentations suggest a role of the peripheral input as a driving factor for inducing sensitization. This may have clinical implications in term of the spreading symptomatology, and may promote the development of pain symptoms. In contrast, as for the NVC, the dental deafferentation is only one of several (unknown) conditions that are necessary but not sufficient for trigeminal neuralgia. Even compression could be an aggravating factor of axonal damages; neurovascular contact could be a triggerpromoting excitability of healthy large myelinated fibers.

Objective: Peripheral nerve field stimulation (PNFS) is a promising modality for treatment of intractable facial pain. However, evidence is sparse. We are therefore presenting our experience with this technique in a small patient cohort. Methods: Records of 10 patients (five men, five women) with intractable facial pain who underwent implantation of one or several subcutaneous electrodes for trigeminal nerve field stimulation were retrospectively analyzed. Patients’ data, including pain location, etiology, duration, previous treatments, long-term effects and complications, were evaluated. Results: Four patients suffered from recurrent classical trigeminal neuralgia, one had classical trigeminal neuralgia and was medically unfit for microvascular decompression. Two patients suffered from trigeminal neuropathy attributed to multiple sclerosis, one from post-herpetic neuropathy, one from trigeminal neuropathy following radiation therapy and one from persistent idiopathic facial pain. Average patient age was 74.2 years (range 57–87), and average symptom duration was 10.6 years (range 2–17). Eight patients proceeded to implantation after successful trial. Average follow-up after implantation was 11.3 months (range 5–28). Using the visual analog scale, average pain intensity was 9.3 (range 7–10) preoperatively and 0.75 (range 0–3) postoperatively. Six patients reported absence of pain with stimulation; two had only slight constant pain without attacks. Conclusion: PNFS may be an effective treatment for refractory facial pain and yields high patient satisfaction.

Neuralgia pós-herpética trigeminal (NPH), neuralgia idiopática do trigêmeo (NIT) e síndrome da ardência bucal (SAB) são doenças neuropáticas da face, caracterizadas por dor na ausência de sinais que evidenciem a causas. Este estudo teve por objetivos determinar as características sensitivas, olfativas, gustativas e salivares em doentes com NPH, NIT e SAB comparados a controles. Foram avaliados 20 doentes de cada grupo, diagnosticados de acordo com critérios da International Association for the Study of Pain (IASP), e 60 indivíduos saudáveis, através de um protocolo sistematizado que incluiu os seguintes testes quantitativos sensitivos: limiares térmicos (frio e calor), limiares mecânicos tácteis, limiares dolorosos de superfície, limiares gustativos (doce, azedo, salgado e amargo), limiares olfativos e fluxo salivar. Os testes foram realizados no território de inervação trigeminal. Os dados foram analisados através dos testes estatísticos ANOVA 1 fator, Tukey, Kruskal-Wallis e Dunn, e o nível de significância foi de 5%. Os limiares térmicos de frio foram diferentes (maiores) somente no ramo mandibular dos doentes com NPH (p=0,001) e os limiares térmicos de calor foram diferentes (maiores) em todos os ramos trigeminais nos doentes com NPH e SAB (p=0,001); a sensibilidade mecânica táctil estava alterada no ramo mandibular de doentes com NPH (p=0,001) e em todos os ramos trigeminais dos doentes com SAB (p= 0,001; p=0,004 e p=0,001); os limiares gustativos salgado e doce, além do limiar olfativo, foram maiores em todos os doentes quando comparados aos controles (p=0,004; p=0,001 e p=0,0389); o sabor ácido obteve os menores limiares e não foram encontradas diferenças para a identificação do sabor amargo ou na avaliação salivar quantitativa (p=0,1694 e p=0,001). Este estudo apresentou evidências de anormalidades sensitivas nos doentes com dor neuropática trigeminal, tanto somestésicas como gustativas e olfativas. A sensibilidade somatosensitiva apresentou-se mais alterada nos doentes com NPH e SAB quando comparados a NIT e aos controles. Mecanismos periféricos e centrais relacionados à percepção e modulação sensitiva podem estar envolvidos na fisiopatologia dos achados aqui observados / Trigeminal postherpetic neuralgia (PHN), idiopathic trigeminal neuralgia (ITN) and burning mouth syndrome (BMS) are painful neuropathies with no clear signs about their causes. The objectives of this study were to determine somatosensory, olfactory, gustative and salivary characteristics of patients with PHN, ITN and BMS compared to controls. Twenty patients from each group, diagnosed according to the criteria from the International Association for the Study of Pain (IASP), and 60 healthy controls were evaluated with a systematized quantitative approach which included thermal (cold and warm), mechanical (tactile), pain, gustative (sweet, sour, salty and bitter) and olfactory thresholds, and quantitative salivary flow evaluation. Data were analyzed with ANOVA 1 factor, Tukey, Kruskal-Wallis and Dunn tests with a level of significance of 5%. Thermal thresholds for cold were different (higher) only in the mandibular branch of patients with PHN (p=0.001) and warm thresholds were higher in all trigeminal branches of PHN and BMS (p=0,001); tactile mechanical sensitivity was altered at the mandibular branch of PHN (p=0,001) and in all trigeminal branches of BMS (p= 0,001; p=0,004 e p=0,001). The salty, sweet and olfactory thresholds were higher in all studied groups (p=0,004; p=0,001 e p=0,0389); the sour threshold was lower and there were no differences in bitter taste or salivary flow (p=0,1694 e p=0,001). This study showed evidences of somatosensory, gustative and olfactory abnormalities in patients with neuropathic orofacial pain. Somatosensory findings were discrete in ITN and more common in PHN and BMS. Peripheral and central mechanisms of perception and modulation could be involved in the physiopathology of these findings

A dor crônica envolve complexos processos de gênese e condução neural e é decorrente da ativação de mecanismos periféricos e centrais de manutenção. Muitos pacientes crônicos são refratários aos diferentes tipos de tratamento propostos, o que gera a suspeita de que de alguma maneira estes não estão sendo totalmente eficazes. O objetivo deste trabalho é avaliar os mecanismos de condução, manutenção e modulação da dor em diferentes condições dolorosas crônicas. Foram avaliadas 92 mulheres, divididas em 5 grupos: Grupo I, 20 pacientes com Dor Miofascial da musculatura mastigatória; Grupo II, 20 pacientes com Fibromialgia; Grupo III, 20 pacientes com Cefaleia Crônica Diária; Grupo IV, 12 pacientes com Neuralgia Trigeminal e Grupo V, 20 pacientes saudáveis assintomáticas. Foram aplicados dois questionários, o IDATE e o OHIP-30, para mensuração do estado ansioso e da qualidade de vida relacionada a condição dolorosa diagnosticada, respectivamente. Todas as pacientes foram submetidas a Testes Quantitativos Sensoriais, como: Limiar de Dor à Pressão, Limiar de Detecção Mecânico, Limiar Doloroso Mecânico, Tolerância à Dor Isquêmica, Sensibilidade Dolorosa ao Frio, Sensação Pós-Estímulo e Controle da Modulação da Dor. Além disso, um Teste Eletrodiagnóstico, que determinou o Limiar de Percepção Atual, através do uso do aparelho Neurometer CPT/C (Neurotron®) foi realizado. Foram avaliadas 3 regiões em cada paciente: trigeminal, cervical e extratrigeminal. Os dados obtidos foram submetidos à análise estatística (ANOVA, Tukey, t-Student) adotando-se um nível de significância de 5% para todos os testes. Todos os grupos experimentais apresentaram altos níveis de ansiedade e grande comprometimento da sua qualidade de vida, quando comparados ao controle. Os Grupos I, II e III apresentaram valores de Limiar de Dor à Pressão significativamente menores do que o Grupo V. As mulheres do Grupo III apresentaram Limiar de Detecção Mecânico significativamente maior do que o Grupo V. Os Grupos I, II, III e IV apresentaram valores de Limiar de Doloroso Mecânico e Tolerância à Dor Isquêmica estatisticamente menores do que o Grupo V. A capacidade de ativação do mecanismo de modulação endógeno, avaliada pelo teste de Controle de Modulação da Dor, está comprometida nas mulheres com Dor Miofascial e Fibromialgia. Não houve diferença estatisticamente significante no Limiar de Percepção Atual (CPT) entre os Grupos I, II, III e V. Pacientes do Grupo IV apresentaram CPT para a frequência de 5Hz significativamente menor do que as do Grupo V na região trigeminal, indicando uma hiperestesia de origem inflamatória no nervo trigêmeo, caracterizando-se a dor neuropática. Ainda, de acordo com os resultados encontrados, os Grupos I, II e III parecem dividir um mecanismo de dor e etiologia semelhantes, não apresentando danos às estruturas neurais e sim uma alteração no processamento e modulação do impulso nociceptivo, caracterizando-se uma dor disfuncional. Os resultados deste estudo mostraram evidências da presença do processo de sensibilização central e prejuízo no mecanismo de modulação endógeno em pacientes com Dor Miofascial, Fibromialgia e Cefaleia Crônica Diária. / Chronic pain involves complex processes of genesis and neural conduction due to activation of peripheral and central mechanisms of pain maintenance. Many chronic patients are refractory to different types of treatment, which leads to the suspicion that somehow they are not fully effective and probably some mechanism of pain generation and/or maintenance is still unknown. Based on that, the aim of the present study is to evaluate the mechanisms of conduction, maintenance and pain modulation in patients with different types of chronic pain conditions. Ninety two women were evaluated, divided into 5 groups: Group I, 20 patients with Myofascial Pain of the masticatory muscles; Group II, 20 patients with Fibromyalgia; Group III, 20 patients with Chronic Daily Headache; Group IV, 12 patients with Trigeminal Neuralgia and Group V, 20 healthy asymptomatic patients. Two questionnaires were used, the STAI and the OHIP-30, to measure state anxiety and quality of life related to painful condition diagnosed, respectively. All patients underwent Quantitative Sensory Tests such as: Pressure Pain Threshold, Mechanical Detection Threshold, Mechanical Pain Threshold, Ischemic Pain Tolerance, Cold Pain Sensitivity, After- Sensation and Control Pain Modulation. An Electrodiagnostic Test, the Current Perception Threshold, using the apparatus Neurometer CPT/C (Neurotron®) was also performed. Three different regions were evaluated for each patient, for each test: trigeminal, cervical and extratrigeminal. Data were gathered and subjected to statistical analysis (ANOVA, Tukey, t-Student), adopting a significance level of 5% for all tests. All patients had high levels of anxiety and greater impairment of their quality of life, when compared to controls. Groups I, II and III showed significantly lower values of Pressure Pain Threshold than Group V. Group III had a significantly higher Mechanical Detection Threshold than Group V. Groups I, II, III and IV showed statistically lower values for Mechanical Pain Threshold and Ischemic Pain Tolerance than Group V. The ability to activate the mechanism of endogenous modulation, evaluated with the Controled Pain Modulation test, is impaired in women with Fibromyalgia and Myofascial Pain. There was no significant differences in the Current Perception Threshold (CPT) between Groups I, II, III and V. Group IV showed a CPT to 5 Hz frequency significantly lower than Group V for the trigeminal region, indicating an hyperesthesic condition due to inflammation of the trigeminal nerve, characterizing neuropathic pain. According to the results, Groups I, II and III seem to share a common pain mechanism and similar etiology, with no significant damage to neural structures but a change in the processing and modulation of nociceptive stimuli, characterizing a dysfunctional pain. The results of this study showed evidence of the presence of central sensitization process and impaired endogenous modulation system in patients with Myofascial Pain, Fibromyalgia and Chronic Daily Headache.

A dor crônica envolve complexos processos de gênese e condução neural e é decorrente da ativação de mecanismos periféricos e centrais de manutenção. Muitos pacientes crônicos são refratários aos diferentes tipos de tratamento propostos, o que gera a suspeita de que de alguma maneira estes não estão sendo totalmente eficazes. O objetivo deste trabalho é avaliar os mecanismos de condução, manutenção e modulação da dor em diferentes condições dolorosas crônicas. Foram avaliadas 92 mulheres, divididas em 5 grupos: Grupo I, 20 pacientes com Dor Miofascial da musculatura mastigatória; Grupo II, 20 pacientes com Fibromialgia; Grupo III, 20 pacientes com Cefaleia Crônica Diária; Grupo IV, 12 pacientes com Neuralgia Trigeminal e Grupo V, 20 pacientes saudáveis assintomáticas. Foram aplicados dois questionários, o IDATE e o OHIP-30, para mensuração do estado ansioso e da qualidade de vida relacionada a condição dolorosa diagnosticada, respectivamente. Todas as pacientes foram submetidas a Testes Quantitativos Sensoriais, como: Limiar de Dor à Pressão, Limiar de Detecção Mecânico, Limiar Doloroso Mecânico, Tolerância à Dor Isquêmica, Sensibilidade Dolorosa ao Frio, Sensação Pós-Estímulo e Controle da Modulação da Dor. Além disso, um Teste Eletrodiagnóstico, que determinou o Limiar de Percepção Atual, através do uso do aparelho Neurometer CPT/C (Neurotron®) foi realizado. Foram avaliadas 3 regiões em cada paciente: trigeminal, cervical e extratrigeminal. Os dados obtidos foram submetidos à análise estatística (ANOVA, Tukey, t-Student) adotando-se um nível de significância de 5% para todos os testes. Todos os grupos experimentais apresentaram altos níveis de ansiedade e grande comprometimento da sua qualidade de vida, quando comparados ao controle. Os Grupos I, II e III apresentaram valores de Limiar de Dor à Pressão significativamente menores do que o Grupo V. As mulheres do Grupo III apresentaram Limiar de Detecção Mecânico significativamente maior do que o Grupo V. Os Grupos I, II, III e IV apresentaram valores de Limiar de Doloroso Mecânico e Tolerância à Dor Isquêmica estatisticamente menores do que o Grupo V. A capacidade de ativação do mecanismo de modulação endógeno, avaliada pelo teste de Controle de Modulação da Dor, está comprometida nas mulheres com Dor Miofascial e Fibromialgia. Não houve diferença estatisticamente significante no Limiar de Percepção Atual (CPT) entre os Grupos I, II, III e V. Pacientes do Grupo IV apresentaram CPT para a frequência de 5Hz significativamente menor do que as do Grupo V na região trigeminal, indicando uma hiperestesia de origem inflamatória no nervo trigêmeo, caracterizando-se a dor neuropática. Ainda, de acordo com os resultados encontrados, os Grupos I, II e III parecem dividir um mecanismo de dor e etiologia semelhantes, não apresentando danos às estruturas neurais e sim uma alteração no processamento e modulação do impulso nociceptivo, caracterizando-se uma dor disfuncional. Os resultados deste estudo mostraram evidências da presença do processo de sensibilização central e prejuízo no mecanismo de modulação endógeno em pacientes com Dor Miofascial, Fibromialgia e Cefaleia Crônica Diária. / Chronic pain involves complex processes of genesis and neural conduction due to activation of peripheral and central mechanisms of pain maintenance. Many chronic patients are refractory to different types of treatment, which leads to the suspicion that somehow they are not fully effective and probably some mechanism of pain generation and/or maintenance is still unknown. Based on that, the aim of the present study is to evaluate the mechanisms of conduction, maintenance and pain modulation in patients with different types of chronic pain conditions. Ninety two women were evaluated, divided into 5 groups: Group I, 20 patients with Myofascial Pain of the masticatory muscles; Group II, 20 patients with Fibromyalgia; Group III, 20 patients with Chronic Daily Headache; Group IV, 12 patients with Trigeminal Neuralgia and Group V, 20 healthy asymptomatic patients. Two questionnaires were used, the STAI and the OHIP-30, to measure state anxiety and quality of life related to painful condition diagnosed, respectively. All patients underwent Quantitative Sensory Tests such as: Pressure Pain Threshold, Mechanical Detection Threshold, Mechanical Pain Threshold, Ischemic Pain Tolerance, Cold Pain Sensitivity, After- Sensation and Control Pain Modulation. An Electrodiagnostic Test, the Current Perception Threshold, using the apparatus Neurometer CPT/C (Neurotron®) was also performed. Three different regions were evaluated for each patient, for each test: trigeminal, cervical and extratrigeminal. Data were gathered and subjected to statistical analysis (ANOVA, Tukey, t-Student), adopting a significance level of 5% for all tests. All patients had high levels of anxiety and greater impairment of their quality of life, when compared to controls. Groups I, II and III showed significantly lower values of Pressure Pain Threshold than Group V. Group III had a significantly higher Mechanical Detection Threshold than Group V. Groups I, II, III and IV showed statistically lower values for Mechanical Pain Threshold and Ischemic Pain Tolerance than Group V. The ability to activate the mechanism of endogenous modulation, evaluated with the Controled Pain Modulation test, is impaired in women with Fibromyalgia and Myofascial Pain. There was no significant differences in the Current Perception Threshold (CPT) between Groups I, II, III and V. Group IV showed a CPT to 5 Hz frequency significantly lower than Group V for the trigeminal region, indicating an hyperesthesic condition due to inflammation of the trigeminal nerve, characterizing neuropathic pain. According to the results, Groups I, II and III seem to share a common pain mechanism and similar etiology, with no significant damage to neural structures but a change in the processing and modulation of nociceptive stimuli, characterizing a dysfunctional pain. The results of this study showed evidence of the presence of central sensitization process and impaired endogenous modulation system in patients with Myofascial Pain, Fibromyalgia and Chronic Daily Headache.

Neuralgia pós-herpética trigeminal (NPH), neuralgia idiopática do trigêmeo (NIT) e síndrome da ardência bucal (SAB) são doenças neuropáticas da face, caracterizadas por dor na ausência de sinais que evidenciem a causas. Este estudo teve por objetivos determinar as características sensitivas, olfativas, gustativas e salivares em doentes com NPH, NIT e SAB comparados a controles. Foram avaliados 20 doentes de cada grupo, diagnosticados de acordo com critérios da International Association for the Study of Pain (IASP), e 60 indivíduos saudáveis, através de um protocolo sistematizado que incluiu os seguintes testes quantitativos sensitivos: limiares térmicos (frio e calor), limiares mecânicos tácteis, limiares dolorosos de superfície, limiares gustativos (doce, azedo, salgado e amargo), limiares olfativos e fluxo salivar. Os testes foram realizados no território de inervação trigeminal. Os dados foram analisados através dos testes estatísticos ANOVA 1 fator, Tukey, Kruskal-Wallis e Dunn, e o nível de significância foi de 5%. Os limiares térmicos de frio foram diferentes (maiores) somente no ramo mandibular dos doentes com NPH (p=0,001) e os limiares térmicos de calor foram diferentes (maiores) em todos os ramos trigeminais nos doentes com NPH e SAB (p=0,001); a sensibilidade mecânica táctil estava alterada no ramo mandibular de doentes com NPH (p=0,001) e em todos os ramos trigeminais dos doentes com SAB (p= 0,001; p=0,004 e p=0,001); os limiares gustativos salgado e doce, além do limiar olfativo, foram maiores em todos os doentes quando comparados aos controles (p=0,004; p=0,001 e p=0,0389); o sabor ácido obteve os menores limiares e não foram encontradas diferenças para a identificação do sabor amargo ou na avaliação salivar quantitativa (p=0,1694 e p=0,001). Este estudo apresentou evidências de anormalidades sensitivas nos doentes com dor neuropática trigeminal, tanto somestésicas como gustativas e olfativas. A sensibilidade somatosensitiva apresentou-se mais alterada nos doentes com NPH e SAB quando comparados a NIT e aos controles. Mecanismos periféricos e centrais relacionados à percepção e modulação sensitiva podem estar envolvidos na fisiopatologia dos achados aqui observados / Trigeminal postherpetic neuralgia (PHN), idiopathic trigeminal neuralgia (ITN) and burning mouth syndrome (BMS) are painful neuropathies with no clear signs about their causes. The objectives of this study were to determine somatosensory, olfactory, gustative and salivary characteristics of patients with PHN, ITN and BMS compared to controls. Twenty patients from each group, diagnosed according to the criteria from the International Association for the Study of Pain (IASP), and 60 healthy controls were evaluated with a systematized quantitative approach which included thermal (cold and warm), mechanical (tactile), pain, gustative (sweet, sour, salty and bitter) and olfactory thresholds, and quantitative salivary flow evaluation. Data were analyzed with ANOVA 1 factor, Tukey, Kruskal-Wallis and Dunn tests with a level of significance of 5%. Thermal thresholds for cold were different (higher) only in the mandibular branch of patients with PHN (p=0.001) and warm thresholds were higher in all trigeminal branches of PHN and BMS (p=0,001); tactile mechanical sensitivity was altered at the mandibular branch of PHN (p=0,001) and in all trigeminal branches of BMS (p= 0,001; p=0,004 e p=0,001). The salty, sweet and olfactory thresholds were higher in all studied groups (p=0,004; p=0,001 e p=0,0389); the sour threshold was lower and there were no differences in bitter taste or salivary flow (p=0,1694 e p=0,001). This study showed evidences of somatosensory, gustative and olfactory abnormalities in patients with neuropathic orofacial pain. Somatosensory findings were discrete in ITN and more common in PHN and BMS. Peripheral and central mechanisms of perception and modulation could be involved in the physiopathology of these findings