Medical Management of Trigeminal Neuralgia

Medical Management of Trigeminal Neuralgia

Niushen Zhang
DOI: 10.4018/978-1-5225-7122-3.ch029
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The first-line treatment of trigeminal neuralgia can be very effective, but side effects are often difficult for patients to tolerate. This chapter is a guide to the broad selection of medical therapies currently available for the treatment of trigeminal neuralgia which includes oral therapies and other non-surgical methods of treatment such as IV medications, nasal sprays, topical ointments, and injections. The discussion of each treatment includes discussion of its evidence in current literature, its proposed mechanism of action, its dosing and appropriate setting for clinical use, and its side effect profile.
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Part 1: First-Line Therapy

Treatment of trigeminal neuralgia should begin with either carbamazepine or with oxcarbazepine, as agreed upon by the American Academy of Neurology and the European Federation of Neurological Societies (Cruccu & Truini, 2013). When a patient does not respond to either carbamazepine or oxcarbazepine, or if the patient cannot take these medications because of contraindications or intolerable side effects, then the patient is defined as having refractory trigeminal neuralgia (Cruccu, 2013).

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