A large group of patients have atypical facial neuralgia characterized by severe boring, at times burning, pain, not limited to the distribution of a cranial nerve but occurring back of the eye, over the zygoma, cheek or nose and occasionally over the mastoid region and down the neck. It cannot be brought on by touching or moving the area and is not lancinating as is trigeminal neuralgia. This syndrome is often temporarily relieved by cocainizing the sphenopalatine ganglion, and Sluder, who first described the condition, thought that permanent relief was sometimes obtained by the injection of alcohol into that ganglion. I have seen patients relieved after cocainization but not after injection of alcohol.
Hypotheses as to the production of this pain are many. Davis and Pollock1 stated the belief that they had disproved experimentally the existence of afferent sympathetic fibers. It was their opinion that stimulation of the efferent sympathetic
MARTIN RC. ATYPICAL FACIAL NEURALGIA. Arch Otolaryngol. 1942;35(5):735–739. doi:10.1001/archotol.1942.00670010742004
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