Word: douloureux
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...returns. Very quickly--Carey mimes perfectly the Victorian novelist's skill at making the implausible seem inevitable--Maggs comes to the attention of one of his master's dinner guests, the rising young author Tobias Oates. When Maggs, serving the wine, collapses from the pain of a tic douloureux in his cheek, Oates volunteers to relieve the servant's anguish by mesmerizing, i.e., hypnotizing, him. Maggs, a man desperate to keep secrets, is at the mercy of Oates, a man avid to exploit them...
Surgery may also be appropriate in cases of the severe facial pain known as trigeminal neuralgia, or tic douloureux. For 16 years, Dr. Mat Boname, 81, of Oxford, N.Y., suffered this excruciating pain, despite the efforts of five doctors. Finally, a delicate operation in which electrically induced heat was used to destroy a facial nerve brought relief. The effect was immediate, he says: "When I came up from the operating room, I had no pain...
...treatment can be repeated if pain recurs. Other neurosurgical procedures involve cutting the roots of nerves at the spine to relieve cancer pain in the lower end of the backbone, and cutting or chemically killing the trigeminal nerve in the face to halt the agonizing stabs of tic douloureux, the most agonizing form of neuralgia...
Many neurosurgeons would stay the knife if they could, and are joining with pharmacologists to develop better ways of relieving pain with drugs. As many as 65% of tic douloureux victims can be treated effectively, says Crue, with drugs originally designed to control epileptic seizures. For the relief of severe pain of virtually every kind, morphine and its synthetic analogues remain the most potent drugs known,* but all are highly addicting and need to be taken in stepped-up doses to maintain a constant level of analgesia. Supposedly nonaddicting substitutes are exultantly reported almost every year by research chemists...
Carbamazepine, to be sure, is not the answer for all tic douloureux victims. Dr. Amols made clear that ten patients had to quit it because of such side effects as severe rashes; four enjoyed only temporary benefit and then required surgery, while six got only the bad side effects. But as evidence of its value, Dr. Amols noted that before he began using it, his institute averaged 28 operations a year for tic douloureux; in one year with the new drug, the number dropped to 18, and last year to six. This year there has not been...