Diagnosis And Treatment options For Trigeminal Neuralgia

Diagnosis

The diagnosis of Trigeminal Neuralgia is a clinical decision and does not require any other investigations. However, certain criteria have been defined to help in coming to this decision. This is just an aid for the clinician and includes certain things like the presence of ocular reflexes, absence of muscular weakness and the presence of pain which is piercing in nature and precipitated through trigger zones.

Treatment Options

The treatment for chronic pain disorders is difficult in general, and even more so when the cause is unknown. There are quite a few options available to the patients today which can help them manage Trigeminal Neuralgia and live a normal life.

The first choice drug is the anti-convulsant Carbamezapine. This drug is usually used in the treatment of epilepsy patients and has been successful in the treatment of idiopathic Trigeminal Neuralgia. The second line of drugs includes Gabapentin and Phenytoin. Often these drugs will be used in conjunction with Carbamezapine.

The treatment with drugs is more effective if Trigeminal Neuralgia has been diagnosed at an early stage and is contained to one branch of the trigeminal nerve. Over a period of time the effectiveness of these drugs can reduce and may require a surgical intervention.

Earlier surgical options for Trigeminal Neuralgia used to be crude, betraying a lack of understanding of the disease. The use of alcohol injections along the path of the nerve at various parts used to be popular, however this is an extremely hit and miss option. The idea was to destroy the pain fibers, however the selectivity for those fibers by alcohol was extremely low.

Patients have reported a high level of relief after these surgical procedures. It should be remembered that these surgeries carry the risk of permanent anesthesia over the face as well something called as anesthetic dolorosa. These can be disabling to the patient and can actually leave a patient worse off than before. Out of the three surgical options mentioned, recent peer reviews have found the microvascular decompression technique to be the most successful at relieving pain as well as having the least chance of serious complications.

See Also: Can Nerve Stimulation Really Help In Alleviating Pain?

One important thing to remember here is that all surgical procedures were found to be more effective in Trigeminal Neuralgia cases that were detected early and were limited in their extent to one branch of the nerve.

Conclusion

While Trigeminal Neuralgia is a chronic pain disorder that has the potential to greatly affect your lifestyle and choices, it is being managed without too much trouble by the vast majority of patients suffering from it. As in any other condition, the key lies with early detection and beginning proper treatment as soon as possible for the best chance of a favorable outcome.