Considerations on the cause and treatment of trigeminal neuralgia

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Abstract
Traction on the 3rd division of the trigeminal nerve secondary to asymmetric jaw protrusion is postulated to be the causative factor in "cryptogenic" trigeminal neuralgia. Homolateral involvement of the other 2 divisions is considered to result from displacement of these structures against bony and dural landmarks. Correction of the underlying jaw abnormalities found in 10 consecutive patients with trigeminal neuralgia, using manual retraction of the mandible for 10 minutes thrice daily, resulted in a progressive decline in frequency and severity of pain, eventuating in an asymptomatic state within 1 week in 6 patients and within 1 month in the remainder. The dramatic temporary cessation of pain within minutes of attaining the corrective position and the aggravation of symptoms by forcible overprotrusion further emphasize the importance of proper maxillomandibular relationships.

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