The treatment of trigeminal neuralgia

The Treatment Medicd

of Trigeminal

Jourd,

Neuralgia:

Ey Stuart

N. Rowe, Pennsylvaniu

March, 1941.

Three therapeutic measures are considered effective in the treatment for tic douloureux; trichlorethglene inhalat,ions, alcohol injections, and section of the nerve. Trichlorethylene, a volatile dru, u which produces rather marked cerebral circulatory change, used at regular intervals as an inhalant has given some patients relief. Alcohol when injected gives temporary relief; it usually requires no hospitaliza,tion and is free from any mortality. Five per cent of the patients injected were not, relieved while the average period of relief in 156 injections was eleven months. When injections are repeated the period of relief becomes shorter, due to the accumulation of scar tissue about the nerve. Surgery is usually the final treatment, for patients who have had almost everything else therapeutically. The simplest operat,ion is the avulsion of the peripheral branches such as the supraorbital or infraorbital. The subntmtnl approach of Frazier was used in the majority of cases. iilcohol

Result

Injections: Supraorhital ______-_--_--_--------------Tnfraorbital _-_____-_--_--_--------------Maxillary --_------~--~--~--~-___ Mandibular -~-----~--~-~_--~_~_Average duration of pain relief ful -----------~---------------------Unsuccessful -_--------_--_--------------of operation in 202 patients:

(i 20 --_--_-- 35 -_--_ ---10 when swces:R11 5.1

per cent percent percent, per cent months per cent Per

Casrs

C’omplrtely reliewl Pain recurred in reoperaticm Tractotonly-lrrarketl

of pnin with the operation area supplied 1)~ uncut nerve but

not

complete

relief

19s relierr.1

ly

cmt

9Y.l 0~3 1

1.1 .03

The following tables should be of interest : ColLcZu.sion.s.-The majority of patients suffering from trigeminal neuralgia eventually come to surgery and here records prove this met,hod of t,reatment highly successful. 1’. J. Cool;.

Superior Love,

Laryngeal Proc. Staff

Neuralgia

: 1:~ IJ. A. Smith, II. J. Moersch,

Meetings,

Mayo

and J. 0. Clinic 16: No. 11, March 12, 1941.

The pain in superior laryngeal neuralgia is severe, lancinating and paroxysmal in type and is not unlike that of tic douloureux. It manifests itself in the side of the neck often upward to the fa.ce as high as the zygoma and downward to the upper portion of the thorax. The pain is often brought on by swallowing solids or fluids and yawning or coughing. During an attack, there is a tendency to swallow frequent,ly, and there may be a drooling of saliva toward the end of the atta.ck. Superior laryngeal neuralgia must be differentiated from glossopharyngeal neuralgia, in which the pain is usually centered on the tonsilar region, and