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February 1958

Treatment of First-Division Tic Douloureux by Peripheral Neurectomy

Author Affiliations

New Brunswick, N. J.

AMA Arch Ophthalmol. 1958;59(2):243-246. doi:10.1001/archopht.1958.00940030111011

The frequency of typical and atypical neuralgias of the fifth nerve has produced a wealth of material dealing with the control of this type of pain. Neurosurgeons have enjoyed a moderate degree of success with alcohol injections or neurectomies of the several peripheral branches of the ophthalmic nerve. Posterior rhizotomy and more recently tractotomy have been popular neurosurgical procedures.

Rather than attempt to explain the origin of typical or atypical tic douloureux, properly in the field of neurological or neurosurgical investigation, 1 shall simply describe the characteristic torments of two patients and what was done about it. In each case the pain was confined to the areas of distribution of the ophthalmic nerve.

In April, 1955, a 65-year-old man developed a trigger zone at the inner angle of the right eye and at the nares on the right side of the nose. These areas were so exquisitely sensitive that not

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