Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


#Trigeminal Neuralgia.#--A severe form of epileptiform neuralgia occurs
in the branches of the fifth nerve, and is one of the most painful
affections to which human flesh is liable. So far as its pathology is
known, it is believed to be due to degenerative changes in the semilunar
(Gasserian) ganglion. It is met with in adults, is almost invariably
unilateral, and develops without apparent cause. The pain, which occurs
in paroxysms, is at first of moderate severity, but gradually becomes
agonising. In the early stages the paroxysms occur at wide intervals,
but later they recur with such frequency as to be almost continuous.
They are usually excited by some trivial cause, such as moving the jaws
in eating or speaking, touching the face as in washing, or exposure to a
draught of cold air. Between the paroxysms the patient is free from
pain, but is in constant terror of its return, and the face wears an
expression of extreme suffering and anxiety. When the paroxysm is
accompanied by twitching of the facial muscles, it is called _spasmodic
tic_.

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