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Article
May 1941

TIC DOULOUREUXRELATION OF "TRIGGER ZONES" TO PAINFUL SEIZURES; REPORT OF A CASE

Author Affiliations

IOWA CITY
From the Department of Surgery, Neurosurgical Service, College of Medicine, State University of Iowa.

Arch Surg. 1941;42(5):913-916. doi:10.1001/archsurg.1941.01210110115009
Abstract

In a previous publication1 I discussed the advantages of a partial section of the sensory root of the fifth cranial nerve in the treatment of tic douloureux. Careful studies of sensory losses were made postoperatively and correlated with the proportion of root section. It was uniformly and consistently observed that when a third (always the superior-mesial third) of the root was spared the patient was subjectively unaware of any significant sensory loss in the face. Diminution in sensation could be demonstrated by objective tests. The zones of such diminished sensation involved the oral and perioral region—the tongue, gums, buccal mucosa, lips and chin—but even in these zones touch and pain sensibility were not completely abolished. It was my impression that pain sensibility was diminished to a greater degree than was touch sensibility. The zones of diminished sensibility did not agree in extent or configuration with the proposition that each

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