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Trigeminal Neuralgia

Noah M. Rosenberg, MD, MBA Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A painful disorder of the sensory nucleus of the trigeminal nerve (cranial nerve [CN] V) that produces episodic, paroxysmal, severe, lancinating facial pain lasting seconds to minute...

DIAGNOSIS

HISTORY

Paroxysms of pain in the distribution of the trigeminal nerve. The trigeminal nerve has three branches and innervates the entire side of the face. They are known as ophthalmologic (V1...

TREATMENT

GENERAL MEASURES

  • Outpatient

  • Drug treatment is first line.

  • Invasive procedures are reserved for patients who cannot tolerate, fail to respond to, or relapse after chronic drug treatment.

  • Avoid st...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Regular outpatient follow-up to monitor symptoms and therapeutic failure 

Patient Monitoring

REFERENCES

1
Wiffen PJ, Derry S, Moore RA, et al. Carbamazepine for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev.  2014;(4):CD005451. [View Abstract on OvidMedli...

ADDITIONAL READING

  • Attal N, Cruccu G, Baron R, et al; for European Federation of Neurological Societies. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neur...

CODES

ICD10

  • G50.0 Trigeminal neuralgia

  • B02.22 Postherpetic trigeminal neuralgia

ICD9

  • 350.1 Trigeminal neuralgia

  • 053.12 Postherpetic trigeminal neuralgia

SNOMED

  • 31681005 trigeminal neuralgia (disorder)

  • 1797400...

CLINICAL PEARLS

  • Patients with TN typically have a normal physical exam.

  • The long-term efficacy of pharmacotherapy for TN is 40–50%.

  • If pharmacotherapy fails, stereotactic radiosurgery or surgical microv...

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