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A Comprehensive Review of Trigeminal Neuralgia

  • Other Pain (A Kaye and N Vadivelu, Section Editors)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Trigeminal neuralgia (TN) is characterized by recurrent attacks of lancinating facial pain in the dermatomal distribution of the trigeminal nerve. TN is rare, affecting 4 to 13 people per 100,000.

Recent Findings

Although there remains a debate surrounding the pathogenesis of TN, neurovascular compromise is the most currently accepted theory. Minimal stimulation caused by light touch, talking, or chewing can lead to debilitating pain and incapacitation of the patient. Pain may occur sporadically, though is primarily unilateral in onset. The diagnosis is typically determined clinically. Treatment options include medications, surgery, and complementary approaches.

Summary

Anti-epileptic and tricyclic antidepressant medications are first-line treatments. Surgical management of patients with TN may be indicated in those who have either failed medical treatment with at least three medications, suffer from intolerable side-effects, or have non-remitting symptoms. Surgical treatment is categorized as either destructive or non-destructive. Deep brain and motor cortex neuro-modulatory stimulation are off label emerging techniques which may offer relief to TN that is otherwise refractory to pharmacological management and surgery. Still, sufficient data has yet to be obtained and more studies are needed.

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Author information

Authors and Affiliations

  1. Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA

    Mark R. Jones & Ivan Urits

  2. Department of Anesthesiology, Louisiana State University Health Science Center, New Orleans, LA, USA

    Ken P. Ehrhardt, John N. Cefalu, Julia B. Kendrick, Elyse M. Cornett & Alan D. Kaye

  3. Ochsner Clinic Foundation Medical School, University of Queensland, New Orleans, LA, USA

    Daniel J. Park

  4. Valley Anesthesiology and Pain Consultants, Phoenix, AZ, USA

    Omar Viswanath

  5. Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA

    Omar Viswanath

  6. Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA

    Omar Viswanath

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  1. Mark R. Jones
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Correspondence to Ivan Urits.

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Conflict of Interest

Mark R. Jones, Ivan Urits, Ken P. Ehrhardt, John N. Cefalu, Julia B. Kendrick, Daniel J. Park, Elyse M. Cornett, and Omar Viswanath declare no conflict of interest. Dr. Kaye is a speaker for Depomed, Inc., and Merck, Inc.

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Jones, M.R., Urits, I., Ehrhardt, K.P. et al. A Comprehensive Review of Trigeminal Neuralgia. Curr Pain Headache Rep 23, 74 (2019). https://doi.org/10.1007/s11916-019-0810-0

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