Trigeminal Neuralgia: Difference between revisions
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{ | Trigeminal Neuralgia (TN) is a highly debilitating condition marked by intense, short-lived, and electric shock-like episodes of facial pain that occur repeatedly. | ||
{{PDF|Trigeminal Neuralgia - Lambru 2021.pdf}} | |||
== Investigations == | |||
Magnetic Resonance (MR) imaging should be incorporated into the diagnostic evaluation of TN to assess for the primary form of the disease. | |||
== Diagnosis == | |||
{| class="wikitable" | |||
!International Classification of Headache Disorders edition 3 (ICHD-3) diagnostic criteria for trigeminal neuralgia | |||
|- | |||
|A. Recurrent paroxysms of unilateral facial pain in the distribution(s) of one or more divisions of the trigeminal nerve, with no radiation beyond, and fulfilling criteria B and C. | |||
B. Pain has all of the following characteristics: | |||
# 1. Lasting from a fraction of a second to 2min. | |||
# 2. Severe intensity. | |||
# 3. Electric shock-like shooting, stabbing or sharp in quality. | |||
C. Precipitated by innocuous stimuli within the affected trigeminal distribution. | |||
D. Not better accounted for by another ICHD-3 diagnosis | |||
|} | |||
== Management == | |||
Carbamazepine and oxcarbazepine are considered first-line medications for TN. Additional treatment options include lamotrigine, gabapentin, pregabalin, botulinum toxin type A, and baclofen. These drugs can be used either as standalone treatments or in conjunction with other therapies. | |||
In cases where pain is inadequately managed or patients experience poor tolerance to medical treatments, surgery may be considered. Trigeminal microvascular decompression is the preferred surgical approach for patients with trigeminal neurovascular conflict. Alternatively, neuroablative surgical procedures may be offered in instances where MR imaging does not reveal neurovascular contact or when patients are deemed too frail for microvascular decompression, or if they are unwilling to assume the associated risks. | |||
==References== | |||
<references/> | |||
== Resources == | |||
{{PDF|Trigeminal Neuralgia - Lambru 2021.pdf}}{{Reliable sources}} | |||
[[Category:Mononeuropathies]] | [[Category:Mononeuropathies]] | ||
[[Category:Head and Jaw Conditions]] | [[Category:Head and Jaw Conditions]] | ||
Revision as of 16:14, 23 March 2023
Trigeminal Neuralgia (TN) is a highly debilitating condition marked by intense, short-lived, and electric shock-like episodes of facial pain that occur repeatedly.
Investigations
Magnetic Resonance (MR) imaging should be incorporated into the diagnostic evaluation of TN to assess for the primary form of the disease.
Diagnosis
| International Classification of Headache Disorders edition 3 (ICHD-3) diagnostic criteria for trigeminal neuralgia |
|---|
| A. Recurrent paroxysms of unilateral facial pain in the distribution(s) of one or more divisions of the trigeminal nerve, with no radiation beyond, and fulfilling criteria B and C.
B. Pain has all of the following characteristics:
C. Precipitated by innocuous stimuli within the affected trigeminal distribution. D. Not better accounted for by another ICHD-3 diagnosis |
Management
Carbamazepine and oxcarbazepine are considered first-line medications for TN. Additional treatment options include lamotrigine, gabapentin, pregabalin, botulinum toxin type A, and baclofen. These drugs can be used either as standalone treatments or in conjunction with other therapies.
In cases where pain is inadequately managed or patients experience poor tolerance to medical treatments, surgery may be considered. Trigeminal microvascular decompression is the preferred surgical approach for patients with trigeminal neurovascular conflict. Alternatively, neuroablative surgical procedures may be offered in instances where MR imaging does not reveal neurovascular contact or when patients are deemed too frail for microvascular decompression, or if they are unwilling to assume the associated risks.
References
Resources
== Literature Review ==
Literature Review
- Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf
- Articles from all years: PubMed search, Google Scholar search.
- TRIP Database: clinical publications about evidence-based medicine.
- Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,
