Tractotomy for the Relief of Trigeminal Neuralgia

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Abstract
Results of section of descending trigeminal fibers in the medulla in a series of 124 cases of major trigeminal neuralgia are reviewed. In 40 patients the descending tract was sectioned at the junction of middle and lower thirds of the olive, in the remainder at the level of the obex. The results indicate that the caudal portion of the descending tract and its nucleus is the more important for pain and temp. sensations from the head area. Although trigeminal tractotomy has the advantage of preserving touch sensation, it is a more serious operation than sensory root section and should be reserved for young and middle-aged subjects, in good general condition and with moderate neuralgia.

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