The Patient with Trigeminal Neuralgia
A 33-year-old white female was admitted for a posterior fossa craniectomy for microvascular decompression of the trigeminal nerve. The patient had been suffering for eight years from brief, extremely intense paroxysms of pain, which she described as lightning-like stabbing sensations on her right cheek and around her lips, precipitated by chewing, brushing her teeth, talking, washing her face, and applying make-up. The pain would last seconds to minutes and rarely occurred at night. For the past year, she had been experiencing attacks several times daily, despite carbamazepine 1200mg by mouth daily in four divided doses.
KeywordsSponge Diazepam Fentanyl Propranolol Lidocaine
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