Sensory Retraining: A Cognitive Behavioral Therapy for Altered Sensation

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Peripheral facial neuropathy

Every year in the United States, millions of people suffer from peripheral neuropathy caused by accidental, compressive, or iatrogenic (eg, surgically associated) injury to the peripheral nervous system. Virtually all of the peripheral nerve injuries to the face occur as a result of nerve compression, stretching, or inflammation of the trigeminal nerve. Elucidation of the mechanisms that influence the rate of peripheral nerve repair after injury is of particular importance for the development

Afferent nerve recovery and cortical remodeling after nerve injury

After any degree of peripheral nerve injury, a complex of cellular and molecular signaling alterations is immediately initiated, and the quality of functional recovery tightly correlates to the molecular responses that attempt to repair and restore the nerve to its preinjury state. After resolution of inflammation and edema, the sensory deficits can be attributed to anatomic or functional changes within the peripheral nerve or to changes induced in the central nervous system by the nerve injury

Sensory retraining background

Sensory retraining (also referred to as sensory reeducation) is a cognitive behavioral therapy technique that helps the patient with a nerve injury to meaningfully interpret the altered profile or neural impulses reaching his/her conscious level after the altered sensation area has been stimulated [30]. Moreover, the repetitive neural input from sensory retraining exercises can produce plastic changes in the somatosensory cortex via the same mechanisms underlying those evoked by altered input

Sensory retraining for altered orofacial sensation

The question of whether sensory retraining exercises could be used effectively with patients with altered orofacial sensation was first raised in the literature by Gregg [72] in 1992. In 2001, Meyer and Rath [53] presented a retrospective review of 372 patients who had had a microsurgical repair for a nerve injury after 1981 and for whom at least an 18-month postsurgical follow-up was available. A nonrandom sample of patients had been given facial sensory exercise instructions that incorporated

Summary

  • 1)

    Sensory retraining teaches the patient to ignore or blot out postinjury unpleasant orofacial sensations to optimally tune into and decipher the weakened and damaged signals from the tissues.

  • 2)

    Sensory retraining is a simple, inexpensive, noninvasive exercise program, which initiated shortly after injury, can lessen the objectionable impression of orofacial altered sensations.

  • 3)

    Sensory retraining exercises are most effective in decreasing the perceived burden associated with hypoesthetic orofacial

Acknowledgments

We wish to thank Dr Myron Tucker and the staff at Oral and Maxillofacial Surgery in Charlotte, NC, for their participation in the RCT.

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  • Cited by (0)

    This project was supported in part by National Institute of Health grants R01-DE013967 and R01-DE005215.

    The authors have nothing to disclose.

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