Abstract The most frequent complications caused by operations for the relief of trigeminal neuralgia are well known. They are herpes simplex, neuropathic keratitis, corneal ulcer and opacity, iritis, conjunctivitis, paresthesias, dryness of the nasal mucous membrane, and facial paralysis.1,2 This discussion concerns itself with 4 patients who developed a rare and poorly recognized sequela, that of neurotrophic changes in the skin with ulceration in the trigeminal area several months to several years following section of the sensory root. Since there is little likelihood of replacing the operative approach to the problem of tic douloureux in the foreseeable future, the occasional occurrence of this syndrome seems assured. Trophic disturbances are changes appearing in tissues that have been deprived of certain qualities of sensation, namely those of pain and temperature and light touch; and they conform sharply to neuroanatomic delineations.3 Report of Cases Case 1.— A woman, aged 68, was first seen References 1. From Dr. Hermann Pinkus' review of sections. 2. Peet, M. M.: The Cranial Nerves , in Practice of Surgery , by Lewis, Dean, Hagerstown, Md., W. F. Prior Co., Inc. 1932, Vol. 11, Chap. 2. 3. Adson, A. W.: Diagnosis and Surgical Treatment of Trigeminal Neuralgia , Ann. Otol. 35:601 ( (Sept.) ) 1926. 4. Karnosh, L. J., and Scherb, R. F.: Trophic Lesions in the Distribution of the Trigeminal Nerve , J.A.M.A. 115:2144, 1940.Crossref 5. Howell, R. G.: Trophic Changes in the Skin After Operation on the Trigeminal Nerve , Brit. J. Derm. 67:444-447 ( (Dec.) ) 1955.Crossref 6. Harris, W.: Analysis of 1,433 Cases of Paroxysmal Trigeminal Neuralgia (Trigeminal-Tic) and End-Results of Gasserian Alcohol Injection , Brain 63:209, 1940.Crossref 7. Leinbrock, A.: Trophic Skin Changes After Surgery of the Trigeminal Nerve , Hautarzt 9:346-350 ( (Aug.) ) 1958. 8. Becker, S. W.: Dermatitis in Association with Disease or Injury of the Peripheral Nerves , Arch. Derm. Syph. 12:235, 1925.Crossref 9. Netherton, E. W.: Persistent Dermatitis , J.A.M.A. 100:722-724, 1933.Crossref 10. Stuhmer, A.: Spatfolgen nach operativen Eingriffen am Trigeminus (Ganglion Gasseri) , Hautarzt 3:5458, 1952. 11. Loveman, A. B.: An Unusual Dermatitis Following Section of the 5th Cranial Nerve , Arch. Derm. Syph. 28:369, 1933.Crossref 12. Greenbaum, S.: Postencephalitic Trophic Ulcer , Arch. Derm. Syph. 30:837 ( (Dec.) ) 1934.Crossref 13. Rosenberg, S. J., and Solovay, J: Trophic Ulcer Following Encephalitis Lethargica , Arch. Derm. Syph. 39:825, 1939.Crossref 14. Tschamper, M.: Ein Fall von trophischem ulcus am häutigen und knorpeligen Septum nasi nach Encephalitis lethargica , Arch. Ohr. Nas. Kehlkopfheilk. 41:244-248, 1937. 15. McKenzie, K. G.: Observations on the Results of the Operative Treatment of Trigeminal Neuralgia , Canad. Med. Ass. J. 29:492-496, 1933. 16. Harman, R. R. M.: Crescentric Defect of the Ala Nasi Following Trigeminal Nerve Section (Case No. 8) , Trans. St. John. Hosp. Derm. 42:86, 1959. 17. Savitsky, N., and Elpern, S. P.: Gangrene of Face Following Occlusion of Posterior Inferior Cerebellar Artery , Arch. Neurol. Psychiat. 60:388-391, 1948.Crossref 18. Dechaume, M., and Deliberos, J.: Ulcération trophique du maxillaire supérieur chez une opérée de neuratomie retrogasserienne totale , Rev. Stomatol. 38:194, 1936. 19. Mixter, W. J., in discussion on Grant, F. C.; Graff, R. A., and Lewy, F. H.: Section of the Descending Root of the Fifth Cranial Nerve , Arch. Neurol. Psychiat. 43:498 ( (March) ) 1940.Crossref 20. Spillane, J. D., and Wells, C. E. C.: Isolated Trigeminal Neuropathy: A Report of 16 Cases , Brain 82:391-416, 1959.Crossref 21. Schorstein, J.: Erosion of the Ala Nasi Following Trigeminal Denervation , J. Neuropsychiat. 6:46-51, 1943. 22. Jaeger, H.: New Type of Neurotrophic Ulcer of the Ala Nasi Following Retrogasserian Neurotomy , Dermatologica (Basel) 100:201, 1950.Crossref 23. Philpott, O. S.: Trophic Ulcer Complicating Operative Procedures for the Relief of Trigeminal Neuralgia , Rocky Mountain Med. J. 38:626-629 ( (Aug.) ) 1941.
Archives of Dermatology – American Medical Association
Published: Oct 1, 1962
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera