To the neurologist, bona fide trophic changes are lesions appearing in tissues which have been deprived of certain qualities of sensation, particularly those of pain and temperature.
That portion of the face which is supplied by the trigeminal nerve may be thus denervated by a number of organic disturbances. The neurosurgeon accomplishes this by sectioning the nerve through its peripheral branches, the gasserian ganglion, the posterior root or, more selectively, by the newest procedure devised by Sjöqvist,1 namely cutting the descending spinal tract in the medulla.
Occasionally a tumor or an inflammatory process may be so peculiarly situated near the ganglion or in the brain stem as to interrupt the sensory function and cause some degree of anesthesia in the face. Most striking is the analgesia produced by two well known lesions of the medulla, namely occlusion of the posterior inferior cerebellar artery and syringobulbia.
The whole subject of
KARNOSH LJ, SCHERB RF. TROPHIC LESIONS IN THE DISTRIBUTION OF THE TRIGEMINAL NERVE. JAMA. 1940;115(25):2144–2148. doi:10.1001/jama.1940.02810510020006
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