Dr. 0. Mastalier - M.D. (Germany)

The clinical picture of trigeminal neuralgia is one of the most dreaded pain sensations and at the same time a challenge to therapists.

Decisive for optimal care of patients is the exacting compilation of the history, anamnesia findings, pain analysis and differential diagnostics. The interdisciplinary consillary examination should be exploited to the fullest extent.

Presented in the lecture report are the results of longterm monitoring and control as well as the biological-oriented therapy.

Before treatment was commenced the patients from two groups underwent biological, radiological, orthopedic, otorhinolaryngologic, ophthalmic and dental examinations.

Particular importance was attached to the disturbance field disorders and focus factors. Psycho-social and other possible causes such as immune deficiency and environmental stress were also considered. Considered, more especially were disorders in the crania-gnatho-sacral relation as significant and not very seldom causes.

Only chronic cases of trigeminal neuralgia in the patient collective were included. In the case of all patients there was almost a continuous stereotype increase in the dose of medication, generally Carbamazepine, forced by fear of the pain experience or because of the deficient effect of the dose, a few were also given psycho-pharmaceutics. Uncontrolled self medication has already led in some cases to undesirable stressing of liver and kidney function with simultaneous paradox effect of reduced analgetic effectiveness. Because of the increasing problems an alternative possibility of treatment had to be employed, which was free of side effects as much as possible in order to counteract more, especially the psychical crisis pressure.

The observance of all individual modalities is particularly important. As one therapy acting on the body's own pain retarding system is acupuncture in its body, ear and cerebral acupuncture variations. To the greatest extent the aim behind this change in therapy, was to ensure a significant dampening of the sensitivity to pain, of nociception and the frequency of the attacks, to save the patients from the psy' the through pain paroxysm - and as a result, to also reduce the psychotrope medication.

Treated were also patients who despite preceding irreversible therapies (ambient alcohol injections. periphery neurexeresis or suffered the same pain after neural therapy as well as multimorbide patients.

I would like to mention the following as a result of my own observations: the needled body or ear points evidenced significant differences in temperature measured with a microsensor measuring probe with very fast reaction time and measuring tolerance of 0.2�C measurable over a range of 0 to 40�C.

The long-term monitoring served to assess the success of the treatment and the lasting effect. It was possible not only to take away the fear of pain but also ensure longer intervals free of pain attacks and significant lowering of the sensitivity to pain. Altogether the chance in therapy appeared to be dependent on the individual modalities and the psychological situation. This was obviously very favourable to the patient to get away from feeling dependent on threatened medication. To be seen as an unrestricted advantage in the course of the treatment without side effects, a clear reduction in pain killers and protection of the psyche, the effects of real causal therapy. Epicrisis: The therapy brought month long to two year recidive and painless intervals without having to take the forced earlier medication in considerable number of the treated patients. The results of the treatment of 2 patient groups with 17 and 28 cases were documented with statistics. They characterize the honest efforts to relieve pain according to Galen: