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November 25, 1939


JAMA. 1939;113(22):1952-1955. doi:10.1001/jama.1939.02800470028006

In 1923, one of us1 called attention to the clinical syndrome produced by lesions of the paratrigeminal area. In this small anatomic space are located the sensory and motor roots of the fifth cranial nerve, the gasserian ganglion and its three branches, the carotid artery and the plexus of the sympathetic nerve fibers which surround it, and the oculomotor, trochlear and abducens nerves which innervate the extra-ocular muscles (fig. 1). Obviously, with all these important structures crowded into a small area the potentialities of many symptoms from even a very small lesion are great.

In one of our two cases reported at that time there were excruciating pain in that area of the right side of the face supplied by the ophthalmic and maxillary divisions of the trigeminal nerve and paralysis of the sympathetic nerve fibers innervating the eyeball, as evidenced by a small pupil which failed to dilate