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.
KeywordsTrigeminal Nerve Trigeminal Neuralgia Microvascular Decompression Trigeminal Root Radiofrequency Lesion
Unable to display preview. Download preview PDF.
- 1.Walker A.E.: A History of Neurological Surgery. New York, Hafner Pub Co., 1967, pp 309–313.Google Scholar
- 2.Victor M., Adams R.D.: Diseases of cranial nerves, in Harrison T.R. (ed): Principles of Internal Medicine. New York, McGraw-Hill Book Co, 1980, p 2023.Google Scholar
- 8.Apfelbaum R.I.: Surgery for tic douloureux. Clin Neurosurg 31: 667–683, 1984.Google Scholar
- 9.Lundsford L.D., Apfelbaum R.I.: Choice of surgical therapeutic modalities for treatment of trigeminal neuralgia: microvascular decompression, percutaneous retrogasserian thermal, or glycerol rhizotomy. Clin Neurosurg 31: 319–333, 1984.Google Scholar
- 10.Janetta P.J.: Treatment of trigeminal neuralgia by suboccipital and transtentorial cranial operations. Clin Neurosurg 23: 538–549, 1976.Google Scholar
- 11.Penman J.: Trigeminal neuralgia, in Vinken P.K., Bruyn G.W. (eds): Handbook of Clinical Neurology, New York, Elsevier Publishing Co, 1968, p 296.Google Scholar
- 12.Apfelbaum R.I.: Surgical management of disorders of the lower cranial nerve, in Schmidek H.H., Sweet W.H. (eds): Operative Neurosurgical Techniques, vol 2. New York, Grune & Strutton, 1982, pp 1063–1082.Google Scholar
- 14.Melmon K.L., Gilman A.G.: Drug interactions, in Goodman L.S., Gilman A.G. (eds): The Pharmacological Basis of Therapeutics. New York, Macmillan, 1980, pp 1739–1740.Google Scholar
- 19.Cucchiara R.F.: Positioning the neurosurgical patient: Special considerations. ASA Annual Refresher Course Lectures, 116, 1984.Google Scholar
- 20.Mogos B., Phillips P.L., Apfelbaum R.I., et al: Is right artrial catheterization always indicated for anesthesia in the sitting position? Anesth Analg 61: 205, 1982.Google Scholar
- 21.Frost E.A.M., Rubin R.C.: Posterior Cranial Fossa Surgery, in Frost E.A.M. (ed): Clinical Anesthesia in Neurosurgery. Boston, Butterworth, 1984, pp 155–185.Google Scholar