Trigeminal sensory impairment after soft-tissue injury of the cervical spine

The cutaneous sensibility for vibration and temperature in the trigeminal skin area was examined with quantitative methods in 30 patients with a previous soft-tissue injury of the cervical spine. Sixteen patients with chronic and disabling symptoms had significantly increased thresholds for vibration over the ophthalmic (p less than 0.001) and mandibular (p less than 0.01) divisions of the trigeminal nerve compared with 14 without symptoms. Temperature thresholds were measured in all three divisions of the trigeminal nerve, and were significantly increased in all three compared with controls (p less than 0.001 in ophthalmic division, p less than 0.01 in maxillary and p less than 0.05 in mandibular divisions). The impairment of vibration and temperature sensibility in the trigeminal skin area in patients with chronic symptoms after soft-tissue injury of the cervical spine indicates damage to the central trigeminal system in upper spinal cord segments and ponto-medullary levels of the brainstem.