TY - CHAP M1 - Book, Section TI - Surgical Treatment of Trigeminal Neuralgia A1 - Kaplitt, Michael G. A2 - Diwan, Sudhir A2 - Staats, Peter S. PY - 2015 T2 - Atlas of Pain Medicine Procedures AB - Facial pain can be caused by a variety of factors, including but not limited to dental pathology, trauma, multiple sclerosis, tumors or other brain lesions, temporomandibular joint (TMJ) disorders, and myofascial and psychogenic disorders. Although most of these are difficult to treat with either medical or surgical therapy, it is possible to address the underlying insult (tumor removal, resolving dental pathology, resting the TMJ with a bite block) and improve pain by eliminating the offending agent. Trigeminal neuralgia (TM) is a specific type of facial pain syndrome which can usually be clinically distinguished from these other disorders. Proper recognition of the disorder and accurate diagnosis of TN is critical, since there are numerous therapeutic options that are effective for TN but these are of limited or no clear utility for most of the other forms of facial pain. The first known report of symptoms typical of TN came from the famous physician John Locke in 1677.1 The patient described typical severe, sharp, unilateral pain of the face and lower jaw. Interestingly, the patient had teeth removed without relief. This continues to occur to this day, since minor tooth pathology may lead to dental procedures or extractions in a somewhat speculative attempt to treat facial pain that in fact is TN. Nicolas Andre coined the term “tic douloreux,” another term still in use which describes the facial contraction and contortions that often accompany the paroxysmal pain episodes of TN.2 Until early in this century, TN was still believed to involve the facial nerve because of these often seen contractions, but it has long been established that this is simply a reactive muscular contraction during the severe pain episodes. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1107200661 ER -