Mohammadali M. Shoja, MD Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, Department of Neurosurgery, Indiana University, Indianapolis, Indiana R. Shane Tubbs, MS, PA-C, PhD Pediatric Neurosurgery, Children’s Hospital, Birmingham, Alabama Majid Khalili, PhD Medical Ethics and History of Medicine Research Center, Tabriz University (Medical Sciences), Tabriz, Iran Kazem Khodadoost, PhD Medical Ethics and History of Medicine Research Center, Tabriz University (Medical Sciences), Tabriz, Iran Marios Loukas, PhD Department of Anatomical Sciences, St. George’s University, Grenada, West Indies Aaron A. Cohen-Gadol, MD, MSc Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, Department of Neurosurgery, Indiana University, Indianapolis, Indiana Reprint requests: Aaron A. Cohen-Gadol, MD, MSc, Indianapolis Neurosurgical Group, Department of Neurosurgery, Indiana University, 1801 North Senate Blvd., # 610, Indianapolis, IN 46202. E-mail: acohenmd@gmail.com Received, August 31, 2009. Accepted, December 27, 2009. Copyright © 2010 by the Congress of Neurological Surgeons If a patient with toothache complains of sudden onset jaw pain with the sense of muscle convulsion and anxiety, you must know that the pathology is at the nerves to the teeth and that the cause of muscle convulsion and anxiety is the artery moving close to the nerves or in contact with them.—Esmail Jorjani (1042-1137 AD) Aretaeus of Cappodocia of the first century has been credited as the first to describe trigem- inal neuralgia and William Rose (1847-1910) of King’s College in London with the first success- ful surgical treatment of this entity in 1890. 1 Parenthetically, as we recently reported, the true first successful surgery (neurectomy) for trigem- inal neuralgia was performed by John Murray Carnochan (1817-1887). 2 More recently, trigem- inal neuralgia has often been treated successfully by microvascular decompressive procedures intro- duced by Dandy 3 and Jannetta. 4 One individual, unknown to many Westerners, is Esmail Jorjani (Figure 1), who described var- ious neurological maladies such as trigeminal neuralgia in his writings. 5 In fact, ancient and medieval physicians were aware of this neural- gic pain syndrome. Rhazes briefly mentioned his own experiences with several patients with facial tics, tightness, and convulsive sensation in his text Liber al-Hawi, in which he also quoted Galen as relating this disorder to a “cold temperament.” 6 Although Jorjani was not the first to describe trigeminal neuralgia, his mention of neurovas- cular conflict as its cause appears original. 5 Nicknamed Imam Zeinolabedin or Sharaf al- Din, Esmail Jorjani (Esmail ibn Hassan ibn Mohammad ibn Mahmoud ibn Ahmad Husseini Jorjani) was born in Gorgan on April 19, 1042 AD. His father’s name was Hussein. 7 Little is known about his youth, as he did most of his writing after his seventh decade of life. 8 In Nishapur, a city northeast of present-day Iran, he studied Ilm al-Hadeath and jurisprudence under Abolghasem Qureishi. 9 He then studied medicine under Ibn Abi Sadegh al-Nishapuri, who was known in Persia as the second Hippocrates. 10 Jorjani trav- eled to Qum, Merv, and other Persian states, where he had the opportunity to interact with physicians from present-day Iraq, Khozestan (a southern province), and other regions, as well as pupils of Avicenna (Avicenna died in 1037 AD). 10 In fact, some have thought of Jorjani as an indi- rect student of Avicenna’s because Jorjani is known to have spent time with Ibn Abi Sadegh, who was a student of Avicenna. 11 In 1110 AD, Jorjani traveled to Khwarazm and was well received by the Khwarazm Shah Qutb al-Din Mohammad Anushtegin, a wise and just king of the Khwarazmi dynasty. 9,10 He was appointed director of the HISTORICAL LIBRARY NEUROSURGERY VOLUME 67 | NUMBER 2 | AUGUST 2010 | 431 Esmail Jorjani (1042-1137) and His Descriptions of Trigeminal Neuralgia, Hemifacial Spasm, and Bell’s Palsy ESMAIL JORJANI WAS a prominent Persian physician of the 11th and 12th centuries. We present Jorjani’s descriptions of probable trigeminal neuralgia, hemifacial spasm, and Bell’s palsy. Additionally, on the basis of our translations of his original text, we believe that Jorjani may have been the first to implicate an artery-nerve conflict as an etiology of trigeminal neuralgia. This theory, documented in Jorjani’s Treasure of the Khawarazm Shah and elaborated on by Dandy and Jannetta, constitutes the basis of a modern surgical approach to trigeminal neuralgia. The authors also describe the life and works of Esmail Jorjani and review his Treasure for its descriptions related to the aforementioned cranial nerve pathologies. KEY WORDS: Esmail Jorjani, History, Trigeminal neuralgia, Vascular compression Neurosurgery 67:431-434, 2010 DOI: 10.1227/01.NEU.0000372088.18260.B1 www.neurosurgery-online.com