A FAMILY history of trigeminal neuralgia is uncommon. It is, in fact, almost a clinical rarity. As Stookey 1 points out, if trigeminal neuralgia were an inherited disorder, its familial occurrence would be more frequently observed. There are, however, isolated reported cases of trigeminal neuralgia that would appear to be inherited.2-6 In this paper an unusual familial incidence of trigeminal neuralgia is reported involving six out of seven members of one generation.
Report of CasesCase 1.\p=m-\A 64-year-old white man was admitted to the Veterans Administration Hospital, Coral Gables, in 1952. He had his first attack of trigeminal neuralgia of the second division on the right side at age 32. In 1952, a retrogasserian neurectomy was done with good results; in 1961, he began having attacks on the opposite second division, which were finally relieved by peripheral neurectomy. Case 2.\p=m-\A brother of the patient in case 1, age 62, long suffered from trigeminal neuralgia of the second division, right side, and had complete relief by retro¬ gasserian neurectomy.Case 3.-A sister in the same family, age 69, had attacks on her right side and was also relieved by retrogasserian neurectomy.Case 4.-Another brother, age 80, had his first at¬ tack at age 52 on the right side and was relieved by retrogasserian neurectomy. In 1964, he began to have attacks on the opposite side that required further sur¬ gery. The type of procedure is not known in this case.Case 5.-A brother died at the age of 84 with a 20 year history of trigeminal neuralgia and was never treated surgically.Case 6.-Another sister, age 83, had her first attack of the third division, right side, at age 80 and was relieved by peripheral neurectomy.As far as it is known, there is no history of the disorder in previous generations in this family. The remaining brother has no history of trigeminal neuralgia. It is of interest that two members of the family (case 1 and 3) had a history of hemicrania and scotomata for many years. There is one member of the family (case 5) with a history of seizures which has not been documented.
CommentHarris,2 Castaner-Vendrell and Barraquer-Bordas,3 Lewy and Grant 4 and, more recently, Argenta,5 have all reported on familial occur¬ rence of trigeminal neuralgia. This interesting family is presented because of the very high incidence of trigeminal neu¬ ralgia. No greater one-generation familial in¬ cidence has been noted in the literature.Because of the very nature of this disease, it has been compared to other paroxysmal dis¬ orders such as epilepsy and migraine.1 It is of interest that two members of this family prob¬ ably had migraine. It is noted that five of the six members had attacks beginning on the right side and two of these patients later developed pain on the left; however no conclusions are drawn on the basis of this observation.Although no hereditary factors have been established in trigeminal neuralgia, the family histories of a small percentage of cases such as those represented here indicate the possibility of multip...
