Trigeminal neuralgia (TN): treatment
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Trigeminal neuralgia (TN): treatment. Carbamazepine: level A evidence, Oxcarbazepine: level B evidence. Fully referenced neurology checklist.
First line drug treatments
- Carbamazepine: level A evidence
- Oxcarbazepine: level B evidence
Second line or add-on drug treatments
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Insufficient-evidenced drug treatments
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Acute treatment of relapses: Lidocaine: options
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Acute treatment of relapses: other options
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Microvascular decompression
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Gasserian ganglion neuroablative treatments
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Treatments of refractory cases
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Investigational treatments
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References
- Gronseth G, Cruccu G, Alksne J, et al. Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology 2008; 71:1183-1190.
- Bendtsen L, Zakrzewska JM, Abbott J, et al. European Academy of Neurology guideline on trigeminal neuralgia. Eur J Neurol 2019; 26:831-849.
- Attal N, Cruccu G, Baron R, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol 2010; 17: 1113-1123.
- Chong MS, Bahra A, Zakrzewska JM. Guidelines for the management of trigeminal neuralgia. Cleve Clin J Med 2023; 90:355-362.
- Uniyal R, Paliwal VK, Kumar N, Malhotra HS, Garg RK, Neyaz Z. Teaching NeuroImages: Amlodipine-responsive trigeminal neuralgia: An alibi for vascular compression theory. Neurology 2017; 89:e20.
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