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The common clinical picture in trigeminal neuralgia includes paroxysmal bouts of superficially triggered, shooting facial pain, with pain-free intervals between attacks. In some patients, attacks are superimposed on continuous interictal background pain. An area near the trigeminal-root entry zone is the most prevalent site of nerve compression, often caused by ectatic vascular loops. Surgical decompression often relieves typical trigeminal neuralgia but is less effective for chronic pain. To determine the mechanism of chronic pain in trigeminal neuralgia, these authors evaluated nociceptive blink reflexes and pain-related evoked responses in 42 patients (18 with chronic pain), using a custom-designed concentric planar electrode to increase…