On the treatment of so-called epileptiform neuralgia, or the so-called incurable facial tic / by W.J. Walsham.

  • Walsham, William Johnson, 1847-1903.
Date:
[between 1880 and 1889?]
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of so-called epileptiform neuralgia, or the so-called incurable facial tic / by W.J. Walsham. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    agonising, “ like a bundle of red-hot wires being driven into the face, and then twisted in all directions,” “ like the seizing of all the teeth at once with dental forceps and rocking them to and fro,” “ like crushing the part in a vice,” or “ stabbing it in a thousand places at once with bradawls or sharp needles.” A paroxysm comes on whilst the patient is describing his symptoms. He breaks off in the middle of a sentence or even a word, to undergo his torture ; the muscles of his face may visibly twitch, his conjunctive become suffused, a tear perhaps trickles over his cheek. Suddenly the attack ceases, and with a sigh of relief he resumes the history of his sufferings. A second paroxysm may not occur for half an hour, even though the irritation which produced the first is repeated; but more frequently there will be two or three during the next ten minutes. The number of paroxysms during the twenty-four hours varies greatly; they may occur during the day only, but more frequently during both night and day. Sometimes there may not be more than twenty or thirty in the twenty-four hours ; at other times there may be two or three or even more every half-hour. They vary at different times in the year and are usually worse in the spring. When severe, they make the patient’s life almost unbearable, preventing sleep and rendering the taking of food, which invariably brings them on, a dreaded evil. The treatment may be divided into the Medical and Surgical. Of the former little need be said. Nearly every drug in the Pharmacopoeia has, at one time or another, been tried with but little success. Opium in large doses, as given by Trousseau, undoubtedly relieves the pain for a time; but little per- manent benefit can be expected from it, and the remedy, if remedy it can be called, would appear almost worse than the disease. Aconitia, given internally, has been strongly advised by Gubler as a specific. I tried it in two cases but was dis- appointed. In one patient, the pulse under its use became intermittent every third beat, and it had to be relinquished after a few doses. In neither was any benefit apparent. Among the surgical measures may be mentioned neurotomy or division of the nerve, neurectomy or cutting a piece out of the nerve, nerve-stretching, removal of one of the ganglia connected