The aim is to reduce the attacks of TN and, by lessening the patient's dependence on the pain, to optimise their functional state.
Trigeminal neuralgia (TN) is characterised by attacks of high intensity that cross one or several terminal areas (the jaw, the cheek, the eye and so on) and resemble an electric shock. In patients, a light stimulus in the area of the branches — touching the lip, for example — brings on attacks of pain.
The basis of treatment is anticonvulsant medication – carbamazepine and oxcarbazepine. These medicines work to reduce the pain by inhibiting nerve dysfunction. The dose and the choice of preparation are adjusted to the patient's tolerance.
Where treatment is ineffective, or where side effects become a problem, lamotrigine, gabapentin or baclofen may be used as an alternative. When drug treatment is not sufficient, or the pain becomes constant and uninterrupted, invasive interventions – such as microvascular decompression or stereotactic radiosurgery (Gamma Knife) – may be considered.
Non-drug methods may include nerve injections (local anaesthetic or corticosteroid blocks), psychological support and methods of stress management (for example behavioural therapy).
The aim is to reduce the attacks of TN and, by lessening the patient's dependence on the pain, to optimise their functional state. The doctor draws up an individual treatment protocol along these lines and monitors it.