Neurotrophic Changes in the Trigeminal Territory

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