Trigeminal Neuralgia Relieved by Ophthalmic Anesthetic

To the Editor. —  Trigeminal neuralgia is an ailment of unknown cause for which treatment is generally far from satisfactory. It was therefore a welcome surprise when one of us (M.R.Z.), having had some four acute episodes of the ailment over a 7-year period, found his symptoms completely relieved after ophthalmologic examination prior to cataract removal. The only action in the preliminary workup that may offer an explanation was the instillation of 2 drops of an eye anesthetic (0.5% proparacaine hydrochloride) into the right eye. Divisions 1 and 2, and occasionally 3, of the trigeminal nerve had been affected on the right side. Both the acute symptoms and the dull ache over the temporal distribution of the nerve, which had existed between the acute exacerbations, disappeared. One minor exacerbation occurred 2 weeks later, and it was treated with 2 drops of the same anesthetic agent. Since the initial apparent effect,