Referred Pain After Painful Stimulation of the Greater Occipital Nerve in Humans: Evidence of Convergence of Cervical Afferences on Trigeminal Nuclei

Cranial sensory innervation is supplied mainly by the trigeminal nerves and by the first cervical nerves. Excitatory and inhibitory interactions among those nerve roots may occur in a mechanism called nociceptive convergence, leading to loss of somato-sensory spatial specificity. Three volunteers in...

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Bibliographic Details
Published in:Cephalalgia 2001-03, Vol.21 (2), p.107-109
Main Authors: Piovesan, EJ, Kowacs, PA, Tatsui, CE, Lange, MC, Ribas, LC, Werneck, LC
Format: Article
Language:English
Subjects:
Adult
Afferent Pathways - physiopathology
Cervical spinal cord
Cervical Vertebrae - innervation
Facial Pain - physiopathology
Female
Functional Laterality - physiology
Humans
Male
Migraine Disorders - physiopathology
Nociceptors - physiopathology
occipital nerve block
pain
Spinal Nerve Roots - physiopathology
Trigeminal Nuclei - physiopathology
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Summary:Cranial sensory innervation is supplied mainly by the trigeminal nerves and by the first cervical nerves. Excitatory and inhibitory interactions among those nerve roots may occur in a mechanism called nociceptive convergence, leading to loss of somato-sensory spatial specificity. Three volunteers in an experimental trial had sterile water injected over their greater occipital nerve on one side of the neck. Pain intensity was evaluated 10, 30 and 120 s after the injection. Two of the patients reported intense pain. Trigeminal autonomic features, suggestive of parasympathetic activation, were seen associated with trigeminally distributed pain. These data add to and reinforce previous evidence of convergence of cervical afferents on the trigeminal sensory circuit.
ISSN:0333-1024
1468-2982
DOI:10.1046/j.1468-2982.2001.00166.x