Hello folks. I have the impression that someone is wondering whether or not NICO (neuralgia-inducing cavitational osteonecrosis) causes trigeminal neuralgia. I confess to having made up the name NICO, but now that we know more about ischemic bone disorders (mostly from the orthopedic literature), I usually call it chronic ischemic bone disease (CIBD), and since I am a pathologist my microscopic diagnoses are typically bone marrow edema or a variation of that entity. I personally have never considered NICO to cause trigeminal neuralgia, only that it causes a facial pain that is frequently misdiagnosed as trigeminal neuralgia or atypical facial neuralgia/pain. I added "neuralgia" to the name in order to emphasis this unique feature, just as I added "cavitational" to the name because it is an extremely unique bone change. My take on it today...almost 3 decades later, is that bone marrow ischemia and low grade inflammation must be ruled out via diagnostic anesthesia testing, tech 99 MDP imaging, quantitative ultrasound imaging, etc. before a diagnosis of true neuralgia is given. Simple concept but seldom implemented. As for the "NICO wars", they seem to have died down as we have learned more and more about ischemic marrow diseases. If anyone is truly interested in the topic, I have a 14 part Power Point "hyperlink handout" and a couple of continuing education lectures available in my Dropbox folder of copyright-free Power Point files (3,600 photos). Just email me at [email protected] and I will send you the link.