RT Book, Section
A1 Kaplitt, Michael G.
A2 Diwan, Sudhir
A2 Staats, Peter S.
SR Print(0)
ID 1107200661
T1 Surgical Treatment of Trigeminal Neuralgia
T2 Atlas of Pain Medicine Procedures
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071738767
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1107200661
RD 2024/04/19
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.