Trigeminal neuralgia medical therapy

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Trigeminal neuralgia Microchapters


Patient Information


Historical Perspective



Differentiating Trigeminal Neuralgia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings



Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

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Case #1

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

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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.


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