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13. Trigeminal Neuralgia.

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Title: 13. Trigeminal Neuralgia.
Authors: Snel, Bart Jorrit, Cohen, Steven P., Erdine, Serdar, Day, Miles R., Van Zundert, Jan, Vissers, Kris, Kallewaard, Jan Willem
Source: Pain Practice. Jun2025, Vol. 25 Issue 5, p1-10. 10p.
Subjects: Trigeminal neuralgia treatment, Trigeminal neuralgia, Glycerin, Magnetic resonance imaging, Radiosurgery, Radio frequency therapy, Electrocoagulation (Medicine), Carbamazepine, Compression therapy, Catheter ablation, Surgical decompression, Comorbidity
Abstract: Introduction: Trigeminal neuralgia (TN) is a disorder characterized by recurrent, unilateral brief electric shock‐like pains, abrupt in onset and termination, limited to the distribution of one or more branches of the trigeminal nerve, and triggered by innocuous stimuli. Methods: The literature on the diagnosis and treatment of TN was retrieved and summarized. Results: The diagnosis is made almost entirely based on the patient's history. In classical TN, the neurological examination is typically normal, whereas the exam in secondary TN is focused on surveilling for signs of multiple sclerosis (MS) or a cerebellopontine tumor. The appropriate imaging technique is magnetic resonance imaging (MRI) with contrast of the trigeminal ganglion, which is recommended prior to interventional procedures. The treatment of a patient with TN is a team effort and should always be multidisciplinary, addressing all dimensions of pain. Carbamazepine or oxcarbazepine are first‐line medical treatments. Microvascular decompression (MVD) is the technique of choice for patients without or with minor comorbidities. Percutaneous procedures for TN are mainly radiofrequency thermocoagulation of the branches of the trigeminal nerve introduced by Sweet and Wepsic in 1965, retrogasserian glycerol injection introduced by Hakanson in 1981, and balloon compression introduced by Mullan and Lichtor in 1983. Radiofrequency treatment is recommended in elderly patients or those with major comorbidities. Other techniques such as stereotactic radiosurgery and pulsed radiofrequency treatment are also discussed. Conclusions: Recommendations are based on very low‐quality evidence. MVD and radiofrequency are the preferred invasive treatments, although higher‐quality evidence is necessary to better assess the risk–benefit ratios. [ABSTRACT FROM AUTHOR]
Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: <searchLink fieldCode="JN" term="%22Pain+Practice%22">Pain Practice</searchLink>. Jun2025, Vol. 25 Issue 5, p1-10. 10p.
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  Data: Introduction: Trigeminal neuralgia (TN) is a disorder characterized by recurrent, unilateral brief electric shock‐like pains, abrupt in onset and termination, limited to the distribution of one or more branches of the trigeminal nerve, and triggered by innocuous stimuli. Methods: The literature on the diagnosis and treatment of TN was retrieved and summarized. Results: The diagnosis is made almost entirely based on the patient's history. In classical TN, the neurological examination is typically normal, whereas the exam in secondary TN is focused on surveilling for signs of multiple sclerosis (MS) or a cerebellopontine tumor. The appropriate imaging technique is magnetic resonance imaging (MRI) with contrast of the trigeminal ganglion, which is recommended prior to interventional procedures. The treatment of a patient with TN is a team effort and should always be multidisciplinary, addressing all dimensions of pain. Carbamazepine or oxcarbazepine are first‐line medical treatments. Microvascular decompression (MVD) is the technique of choice for patients without or with minor comorbidities. Percutaneous procedures for TN are mainly radiofrequency thermocoagulation of the branches of the trigeminal nerve introduced by Sweet and Wepsic in 1965, retrogasserian glycerol injection introduced by Hakanson in 1981, and balloon compression introduced by Mullan and Lichtor in 1983. Radiofrequency treatment is recommended in elderly patients or those with major comorbidities. Other techniques such as stereotactic radiosurgery and pulsed radiofrequency treatment are also discussed. Conclusions: Recommendations are based on very low‐quality evidence. MVD and radiofrequency are the preferred invasive treatments, although higher‐quality evidence is necessary to better assess the risk–benefit ratios. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/papr.70051
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        Text: English
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        PageCount: 10
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      – SubjectFull: Trigeminal neuralgia treatment
        Type: general
      – SubjectFull: Trigeminal neuralgia
        Type: general
      – SubjectFull: Glycerin
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      – SubjectFull: Magnetic resonance imaging
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      – SubjectFull: Radiosurgery
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      – SubjectFull: Radio frequency therapy
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      – SubjectFull: Electrocoagulation (Medicine)
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      – SubjectFull: Carbamazepine
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      – TitleFull: 13. Trigeminal Neuralgia.
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              M: 06
              Text: Jun2025
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