The author describes three women who presented psychotic symptoms 24--
48 hours before scheduled neurosurgical procedures for atypical facial
pain; all had had extensive dental reconstruction and attempted nerve
blocks with no relief. Psychiatric hospitalization and administration of
major tranquilizers resulted in control of symptoms and relief of pain. Two
patients were followed for a year and have had return of psychiatric
symptoms or facial pain; both have been maintained on medication and have
returned to normal activities. The author suggests that the facial pain may
have served as a defense against the emergence of psychosis.
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