Sixty patients with idiopathic trigeminal neuralgia (ITN) were clinically investigated and the following results were obtained. 1) The 3rd branch of the trigeminal nerve was involved in 33 patients (55%), the 2nd branch in 23 patients (38.3%), and 1st+2nd or 2nd +3rd branches in 4 patients (6.7%). 2) Most patients underwent nerve block of the infraorbital and mental nerves and received carbamazepine. After frequent nerve block with 0.5% bupivacaine hydrochloride, analgesia of the nerve-inervated tissues persisted for a long period, similar to that during nerve block with 100% alcohol. 3) Within 6 months after successful treatment, pain recurred in 25 patients (41.7%), and re-recurrence occurred in 14 of these 25 patients (56.0%). In addition, ITN recurred three times in 9 of the 14 patients (61.3%). 4) In patients with recurrence, the face and oral cavity were broadly involved and, pain attacks were more frequent than those in patients without recurrence. These results indicate that blockade of the infraorbital and mental nerves by local anesthetics is useful in the management of ITN, that severe ITN tends to recur, and that ITN sometimes worsens during the course of recurrence, which complicates the treatment of ITN.
