Surgery As Option for Face Pain

The recently published guideline deals with how to treat trigeminal neuralgia. Trigeminal neuralgia is a chronic pain condition that causes extreme, stabbing pain throughout the face. The pain normally does not last more than a few seconds or a minute per episode, but the episodes can last for days, weeks, or months and then disappear for months or years.

“There are very few drugs with strong evidence of effectiveness in treating trigeminal neuralgia,” said guideline author Gary Gronseth, Medical Doctor, with the University of Kansas in Kansas City and Fellow of the American Academy of Neurology. “If people fail to respond to these drugs, physicians should not be reluctant to consider referring the patient for surgery. Often surgery is considered a last resort and patients suffer while the well-intentioned physician tries other medications with limited effectiveness.”

The guideline recommends the appropriate drugs be offered as a first-line treatment for people with trigeminal neuralgia. “If patients do not respond well to carbamazepine or one or two other drugs, it is reasonable to consider surgery that targets the root of the trigeminal nerve,” said Gronseth. “People with trigeminal neuralgia should be aware of the availability of surgical treatments and discuss these options with their physicians.”

The guideline that was developed in partnership with the European Federation of Neurological Societies also recommends that physicians consider sending all patients with trigeminal neuralgia for Magnetic Resonance Imaging (MRI) or trigeminal reflex testing since up to 15 percent of patients have an underlying structural cause of the disorder, such as a tumour.

MEDICA.de; Source: American Academy of Neurology