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Trigeminaleuralgia:Whatdoes hePatientNeed?Based att an addrc55givetl at a iaint |rccttnt ot the 8.M.A.5. and tllr: ErlLishSoc:ietvof Meclical aDCl )entalHypnosts ,tt the Roval Sacietv af l\,i-.(]i( ne on 21st O.tabet 1989.

T h e p o i f l siol lorvs:Oph lha lm ic . . .N,l .r\ i l lari ,.......\ '1and ular....

In the earlyyears f my acupun.luf-a.\pefiencewelcomed hc opporlLrni l l ro lr,"rLa Dirtientwrtht r igemrna l cu ra lg ia .l l he p . r i n ! ,as o t en t i re l vremoved t r , r ,as ,n a cons ic le rab leropor t n o fcases,er,v ubst.rfial ly cduced.Pa t i en tsendcd o be re ie r red o n re bec . r sem e d i c a l n r a n a g c n r c n l a d - " i l h e f b e c o m edecrc'asinglyficcl ivewilh subsequentpisodes rh a d p r o v o k c d n d e s i r a b l ei d ee i i e c t s , s o rerample n thc cascoi Tegretol. l tholrgh enerrl lyw e l t o l c r a t c d h i sd r u gh : s b e e n e p o r t e d ss u p p f c s s i r g o r e m a r r o r , , r o v o k l n g p a s t i c' . . . i " r ' r d - r r r r . l u . u i , r . . . . / / t , \l ' , r r . i u n r . r ' - h r l L r ' , . . . r ' r ' )re len l io f , rnc l m l )o tence . u r t i ca l n tc fvc I t i on ,l rom he pa l i - . r ) l ' so in to i v iew,o i t cnsccms n

d , , . . , 1 . L ' a , L r u i - , u , L l . 1 , r J r . . . t .happiera tefnative.l r1 he cdses have reated, hc ophthalmiccl iv is ionof the nerve has becn css requ efl ly ai fecLeclhant h e m a x i 1 a r y n d m a n d i b u l a r r a n ( h e s . y p l c i r_ vl h e c o n d i t i o nm a n r i e s t st s c l i n s h o f t e p i \ o d i .nt lncks, he srccessivc ntcrvals ccrasinB hi e Lheintensity rncldu|at ion of the pain in.reases. t hnsb e e f r a r e o r m e l o s e e a p a l i e n ld u r i n g . r n n i t i n lattac

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l o l j r c s e o n l 5 w o ! d , r . l c l l I l l L h f ) a I \ ! ' l s e f rqr,. ,erc,r i i LL ,) { ) f 20 \\ ' .1s)clrrgLrsf l ,r \ \ \ 'e Linrrr lLR I \ ! ,oLrlcl e adrlcd i lhc pnt e|] l l ppc.ret i 1o )cL c r s e n r l s t r e s s c c l .o l r . L r s e i L l ' 1 n n ' l I R l wa si1 t l r ,r l i rrrcnr,v nlV conccssion o thf rncnl ' l i lnl 'ol t r .rpnLl.nt. '\l\\1d l

e,r i .rr ,rh /)rr l r1J1l rnrn irr l l t r \ i / l . r1tOnrtorr

Al)orr l \ \{r !e.rrs a1yr,ho\r 'cver, n 'dery p:l icnlD r e s ( , n L . d ' t h n i n . a p . 1 i r 1. - ' r h : ' l i ) e c ncl rgri , ,s. ' .1on,e -vcnrs revlotr\ v rs oi l l i .gcnrlnnlu r ' , q i n . " u , " ' 1 , " , i e g L r i . r r r t I n r f . \ ' n k i n E h e1,., i icntp ,r cl1, . :ssl i rr-qrr sp 1eoi,rnalgeslcsLrnt5 . : i ( l r 6 r r r i . \ ' h c r l w o r r l s r r l ) s r d eTl rr - rrrrsrr.r inr{-o i onsel mJtl . nre corrsider hep o s s i b i l v ( ) i r r r . r s s e l e rl ) a s f r p r o v o k e ( lL l ) n c la J r e a n ro n t e r l . | 1s t ( l i n n L \ , r - ' r r L ,s a c n r F l l( ) m et r . r L h e t r e . l l l n e l l Li a h o a t ' w o l Ld , ) c l r y p r l o s 'Afier he firsl sc:siorr i ic h, ld n l) '1n-lrcc \c ' l i $ ' lnr nb ore'nslelcpr.l tL' l oul scs5 lrs shc

wr' ! cr l )alr leni ." i l t ,yp,u. i , , anclslre 'v.:s nt our.rgcd o useLhisD' l)) i ) l ry ln(cn v orl ! :ca)rLwi( ' r n(h week A lol o\{, r r i r n I l ' I |h.rr rcnr,r!r le{lr . l l l l ee

l / .1 , r i r l i I I /a r r r f i r 1 r ] i . ' iI a o ! ( l o i t o L r r . c b e a t g t r e r l h n l s j r e ! n s r is l ] i l c r l n q .r o r l l r i A c r r r i f a l r c l r ; r L B i Jl Ln l l r li f l h r l i r o i h e f l f r r r p c r o r t . r r r t l r r l a l o i rN e - \ , c r t j r cs ! t h e m a n a l f r r e n t o i r c l . o n r l i l i rrrn. le rnc re.on' i i ( lcrnry trenLmcnl i f ' rc i ' r l ' r Ig e r i c r n p o s l r c ) e l i c .r I L h r i l . r n r l l i q e m ' r' | h,rVeno\,r, cv err,ccl hc Ln\1 / patien(s hr\l re,r lccl s )o55 e or probrh e c .rses i l r gt"ni l 'n e u r . r l q i a , a y n q s p e c i f a t t e n L i o r r o L r tp r s , v co l o l i r : a ls t r 1 e s .h e L h l ) l . c o i l c n L r l l f n L lihe rc(un' fn(e o i l l rc syl l l l ) toms hL- ,vp ' rs ( i l !. r r e a c l - v c n Lo n e l l s p a c e r l c h r o n o o S i c a t ;Nr).U n l l ic nr cldleoi the scl ies /\ i lef tre' r l i rrg rrsLra ,v onsir lc lcd Lhf .rpprcprinle|1essl r!pnojior \ub5equfnL ntlef ls . l rrr lToI .r tef c(l l f f rrcc5( F r r t a l r ir r p r c s \ i o n ! o $ c n r e f g c L k f p 0 5

h e r p c t ( n e t r r . l i , r t h e s l n r p l o n t so T f A f n r l 'ncrLfa (r ann bc precl ic l ;rblvessl.rrrL n(l ' r cc J. i r ( L r m s l . r n c e r .l h . p ; r l i c n t ' d e l ) l t n t e ' l p a l !No I | ! \ 'ns { lmltte{l o hospit .r l\ ' th mi rrLrlrion

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I tevie$,ot7 Cas.s t i -b.rpeirnrent,Teatn cntndOut.omePatient Psych.Slale

2 r t1.5l Stable usnessnunL l ' .75 Wofrer MiE'n e.+ N1 5 lenre M l)5 F7l Depresed. lofe6 F.6.1 Uih.pp.! mafri.rserccenlr -p. ! fefae7 N1.60Acco!nl !n l8 F.67 Chccri! w dow9. F60 !1atr l .d Slable10. ,16 strc$cdworkI L M.7ar Dc,prcsscd.lone,receft cc!nrn. :e12.M -17 Hypcrtcnsion.tressI l . f . i1 l Deprfss.d dow1.1F.60 Er Mldr i iel i . r - .51, Manied. t .b le16.F.52 M.r i f iedStnblcI L l\,1..1.145 5t'e$Acu. = A.upuncture.

Sas t r r c ymp ioms,espond o acupL tnc tu rcr ] aBra t i f y l ng l vr i skmanner . - l -hc,v idow iv ing nisol.rt ionpaticntNo. 13)getsafiackswo or threel j n l e se a c h y e a r , o m p e l l i n g e r t o t r a v c l aconsiderablcislanceo the ci ly where pracl ise,whercsheslays vith a chccriulTnarfieosrerwnofusses veT e r .Th ree r four weeks f th i sp lusacupunclure,nd hersymptonts odifyenough oreturn ome.Shehasconsistcntlyefused ypnosis,and he las lse r ies f t r ea tmcn l s as ominous lyunsucccssiLrl .I now ofler hecomplcrnenlaryher.rpy i hvpnosisrs an adjuncl n ,rconsiderableroportion f cases,whenevefhcre s hepossibi l i lyi r. j ld depression.Therehave beencovert cjecl ionswhere hcre isresistanceven1() elaxation,nd therehavebeenovert relusals/ special lyrom patjents resentingwith a third or iolfth recurrence-hey havc ]eencond i t ioncdo an t i c i pa tee l ie fby acup !nc tu rea lone , nd sc e no po in t n in l roduc ingsecondrferapy.I n a l l c a s e s h a v eb e c o m e e f 5 i t i v e o t h cpmo l i u ' l . rl . pJ . ^ f h - . - n , ' . r t . . r h o r ' , I r , rs o c l o s e l y s s o c i a t e d i t h d e p r e s s r o nh a t lbecomes iff icult o identi fy he primary ondition.Perhapshatdisl inctions notof great mportancefu r r ' * n - b ' t . t L , r , L n J t ) , r I er , l h r p r o .. a r rb- muhr.r ly supportive.

Dt Maty lenkinsBScMR BChDPHPastChairmaDBMAS60 Cathe.lralRaad,Cardiff

an ear l ya t tack ) , lde r l y , i v i nga loneo r w i th an!nsympa thc t i c a r tn -a r ,r i s depressed , to ta lpreoccupaiiolrith symptoms ccomesnevitable.On theotherhancl, usymenor rvomenn their50sor 60s, vhoallendbecaLrseheifanalgesicsrovoke

67

lABLL2Re!ie$,oi l5 Paticnts _v e.L tence ,.rrter'rsPatient Alta.ks / Se$ions ResponsesTreatmenlNo. Rccuren.sI 2 7 ea(h. Pain - rcc a. ! ony2. 1 I Rd!.edPaln a. ! . on y. | Pc6islenl vfs 12 RcdlcedPain a. ! . on v6. 2/yr or 5 yrs 6 I Red!.edPain : . ! of lv7. ? in i y 's 7, l i l . Reduced ai i rcu onlyIt. Perslnent _!,s .1 f,3in ree hl,p orlr-r l Per inenl2 vrs 9 Paif Free ecu onl] ,10.P-arr ine. l0 ytr 7 l ,a i f Ffee .c! .+ hyp.l l l4,r of 5 ,rs 6 8 Pai i Free .c! . on ylasl l l3.k .1 Pan Free rc! +counst l12.P-.6is lenl l rs ; Red!.ed je in .rc! +tapcl l I l a i n l a l l y 5 1 6 6 D e c r e a s e d . . u o f l yrcsponsc (rer lseo vpr1.1./vr tor I ! t r ' 68 Decrrcsp acu.only15 sc..ondttrck 2 y6 .1 Pr i f F ee ac! on6. n tia atta.k I Pa I l-rrc a.!. on yI5. l rc lat t - . r vrs 7 Pr lnFree a. ! . + hvt .lwo oi heprt ients crcomnr l l l -pdNos. l . .1 5) onc$l lh. l re! ! s soon shvpnos wesslggetei theotherw thdre$, ito .+unslccessi! rre.rnrenls' Pcrhapshls ex Drd!!iie shouldhavcbcenofier-".]ypnosis.A.u. = A.uPuncture,

to the 1othAnniveuary nternat ionalcongressr theA / i l ' - JL. r-\ tr/r r f n \-.- I alon 25th May 1991.

T h e A . A . G . D u t c h F e d e r a i i o no f P h y s i c i . n s n dDent istspract sing ComplementaryMedicine) s anu m b r e l l a o r g a n i s a t i o n c o v e r l n g a s s o c i a t l o n snmed irF d' d dFi . ' r ) w 'r . . l rppre'enr he marr dred\o f c o m p l e m e n t a r y e d i c i n e n H o l l a n d ,n o t a b l y :Acupuncture,Manipulat lve Medicine,Homeopathy,Neura Therapy, nthroposophy,nd NaturalMedicine.The rneet ingwl be held at the Hote Post i t jon trechtBunnik,Hol and. Your padicipat ionand contr ibutonot papers i l l be welcome.