PT  - JOURNAL ARTICLE
AU  - Khalid W. Al-Quliti
TI  - Update on neuropathic pain treatment for trigeminal neuralgia
AID  - 10.17712/nsj.2015.2.20140501
DP  - 2015 Apr 01
TA  - Neurosciences Journal
PG  - 107--114
VI  - 20
IP  - 2
4099  - http://nsj.org.sa/content/20/2/107.short
4100  - http://nsj.org.sa/content/20/2/107.full
SO  - Neurosciences (Riyadh)2015 Apr 01; 20
AB  - Trigeminal neuralgia is a syndrome of unilateral, paroxysmal, stabbing facial pain, originating from the trigeminal nerve. Careful history of typical symptoms is crucial for diagnosis. Most cases are caused by vascular compression of the trigeminal root adjacent to the pons leading to focal demyelination and ephaptic axonal transmission. Brain imaging is required to exclude secondary causes. Many medical and surgical treatments are available. Most patients respond well to pharmacotherapy; carbamazepine and oxcarbazepine are first line therapy, while lamotrigine and baclofen are considered second line treatments. Other drugs such as topiramate, levetiracetam, gabapentin, pregabalin, and botulinum toxin-A are alternative treatments. Surgical options are available if medications are no longer effective or tolerated. Microvascular decompression, gamma knife radiosurgery, and percutaneous rhizotomies are most promising surgical alternatives. This paper reviews the medical and surgical therapeutic options for the treatment of trigeminal neuralgia, based on available evidence and guidelines.