DrugLib.com — Drug Information Portal

Rx drug information, pharmaceutical research, clinical trials, news, and more

Trigeminal neuralgia: current concepts and management.

Author(s): Das B, Saha SP

Affiliation(s): Bangur Institute of Neurology, Kolkata.

Publication date & source: 2001-12, J Indian Med Assoc., 99(12):704-9.

Publication type: Review

Trigeminal neuralgia is the most frequent cranial neuralgia, the incidence being 1 per 1,000,00 persons per year. It presents with stabbing pain often in the distribution of the mandibular and maxillary divisions of the trigeminal nerve. An accurate history of pain is important in the diagnosis of trigeminal neuralgia. A patient with tic douloureux and no neurological abnormality on clinical examination does not need diagnostic tests. The available options for management of trigeminal neuralgia are: Pharmacotherapy, destructive procedures and non-destructive procedures. The pharmacotherapy includes (i) monotherapy with one anticonvulsant, (ii) combined therapy with more than one anticonvulsant, (iii) add-on therapy with newer drugs and (iv) polytherapy with anticonvulsant + add-on drugs + antidepressants/anxiolytics. Destructive procedures include (i) non-surgical methods--injections along trigeminal pathways, percutaneous trigeminal radiofrequency thermocoagulation and (ii) surgical methods--trigeminal branch avulsion or peripheral neurectomy, avulsion of trigeminal nerve, trigeminal tractotomy, radiosurgery. Though various modalities of treatment are available for the management of trigeminal neuralgia, pharmacotherapy with carbamazepine still remains the first line of treatment. The alternative approach followed at most centres is percuatenous Gasserian rhizolysis (chemical/radiofrequency thermal) or microvascular decompression.

Page last updated: 2006-01-31

-- advertisement -- The American Red Cross
Home | About Us | Contact Us | Site usage policy | Privacy policy

All Rights reserved - Copyright DrugLib.com, 2006-2017