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Descending Trigeminal TractotomyNeurophysiological Approach
Yoshio Hosobuchi, MD;
Burton Rutkin, MS
Arch Neurol. 1971;25(2):115-125.
Abstract
Evoked potentials from peripheral stimulation were monitored centrally to delineate the descending trigeminal tract in six patients with facial pain. Lesions were made in the areas of the tract where maximal evoked potentials were obtained. Pain was completely relieved, while touch sensation and corneal reflexes were retained. Associated analgesia of the ipsilateral pharynx, tympanic membrane, and external auditory meatus, obtained in five of the six patients, indicates the close proximity of the pain and temperature fibers of cranial nerves VII, IX, and X to those of the descending trigeminal tract. This physiological localization of the tract contributes to the accuracy of descending trigeminal tractotomy while avoiding the severe discomfort resulting from direct stimulation in the conscious patient.
Author Affiliations
San Francisco
From the Department of Neurological Surgery and the Cardiovascular Research Institute, University of California, San Francisco.
Footnotes
Accepted for publication Feb 16, 1971.
Read before the annual meeting of the American Association for the Study of Headache (winner of the Harold G. Wolff Award), Chicago, June 20, 1971.
Reprint requests to Department of Neurological Surgery, University of California, Parnassus and Third Avenues, San Francisco 94122 (Dr. Hosobuchi).
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