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1. Trigeminal Neuralgia
Author(s) -
Van Kleef Maarten,
Van Genderen Wilco E.,
Narouze Sem,
Nurmikko Turo J.,
Van Zundert Jan,
Geurts José W.,
Mekhail Nagy
Publication year - 2009
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/j.1533-2500.2009.00298.x
Subject(s) - medicine , trigeminal neuralgia , oxcarbazepine , microvascular decompression , carbamazepine , pulsed radiofrequency , neuralgia , trigeminal nerve , anesthesia , neuropathic pain , pain relief , epilepsy , psychiatry
Trigeminal neuralgia is a common cause of facial pain. It has a significant impact on the quality of life and the socioeconomic functioning of the patient. The aim of this review is to provide recommendations for medical management of trigeminal neuralgia based on current evidence. Based upon the analyses of the literature combined with experience in pain management, symptoms, assessment, differential diagnosis, and treatment possibilities of trigeminal neuralgia are described and discussed. Recommendations for pain management are given and are displayed in a clinical practice algorithm. Treatment should be multidisciplinary. Various treatment options and their risks should be discussed with the patient. The first treatment of choice is carbamazepine or oxcarbazepine. In younger patients, the first choice of invasive treatment is probably microvascular decompression. For elderly patients, radiofrequency treatment of Gasserian ganglion is recommended and the technique is described in detail.