Neuralgias.

Cranial neuralgias are relatively uncommon but the excruciating nature of the pain they cause make them the focus of much clinical and research interest. The underlying mechanism of the disease remains to be uncovered. The complexities of the trigeminal system make the quest for comprehensive understanding a difficult one. Fortunately, pharmacotherapy is quite effective for many patients. For those patients who cannot be managed medically, there are a variety of surgical options. Criteria have been proposed for evaluating surgical efficacy in trigeminal neuralgia. These parameters should be used when considering the surgical options for each patient. Above all, the Latin motto, Primum non nocerum (first, do not harm) should prevail. With this in mind, the physician and surgeon will make the best choice for the care of each patient.