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April 1990

Pimozide Therapy for Trigeminal Neuralgia

Arch Neurol. 1990;47(4):382. doi:10.1001/archneur.1990.00530040022011

To the Editor.  —In their article, Pimozide Therapy for Trigeminal Neuralgia, Lechin et al1 have demonstrated relief of chronic (8 to 17 years) pain in the lower two thirds of the face by the use of pimozide in doses that caused "physical and mental retardation and other symptoms." But was this "trigeminal neuralgia" the classic major paroxysmal pain also known as tic douloureux?The equal numbers of men and women and also the more frequent involvement of the left side of the face than the right are not characteristic of tic douloureux. Likewise, "periods of constant less intense pain" are not tic douloureux, although they may accompany it. Was the pain strictly unilateral? Had there been periods of spontaneous complete remission? Were there refractory periods?In my experience of several hundred cases of tic douloureux, effective medication or surgery either prevents the pain or fails to do so2

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