Trigeminal neuralgia medical therapy

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Trigeminal neuralgia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

There is no cure for trigeminal neuralgia, but most people find relief from medication or sometimes from one of the many so-called complementary or alternative therapies. Atypical trigeminal neuralgia, which involves a more constant and burning pain, is more difficult to treat, both with medications and surgery. During a TN attack, some patients may get quick relief by applying an ice pack or a readily available source of cold temperature to the area of pain.

Medical Therapy

  • If anticonvulsants don't help and surgical options have failed or are ruled out, the pain may be treated long-term with an opioid such as methadone.
  • Low doses of some antidepressants can be effective in treating neuropathic pain.
  • Botox can be injected into the nerve by a physician, and has been found helpful using the migraine pattern adapted to the patient's special needs.

Many patients cannot tolerate medications for years, and an alternate treatment is to take a drug such as gabapentin and place it in an externally applied cream base by a pharmacist who compounds drugs. Also helpful is taking a drug holiday when remissions occur and rotating medications if one becomes ineffective.

References



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