Trigeminal Neuralgia

How Can A Neurologist Help?Summary of a presentation to

Dallas TN AssociationNovember 7th, 2007

Norma Melamed, MD12810 Hillcrest RoadSuite B220Dallas Texas 75230972 991 8466

1) Make the correct diagnosis

Trigeminal neuralgia (TN) is excruciating, brief, electric shock-like facial pain, occurring mostly after age 40

Multiple pain triggers: brushing teeth, chewing, talking, cold air, eating, etc

Neurologic examination to rule out other causes of pain

2) Investigative testing

MRI brain scan – exclude stroke, tumor, MS

Magnetic Resonance Arteriogram (MRA) – exclude aneurysms, vascular malformations

3) Medical management of pain

Carbamazepine, oxcarbazepine, gabapentin, pregabalin, phenytoin, valproate, lamotrigine, topiramate, clonazpam, baclofen, amitriptyline, duloxetine, are frequently prescribed

4) Advise when to consider surgery

If medical treatment fails If medication side-effects are

intolerable

5)Conclusion

TN is a very treatable disorder that can usually be managed medically, and long-term control achieved