Treatment of
trigeminal neuralgia
The treatment of trigeminal neuralgia is complex, it should preferably be carried out with a neurologist and should address three directions:
Acute pain treatment
The crisis prevention
The treatment of the cause
Abortive treatment is the one that seeks to treat the pain as soon as it arises. As the pain is usually extremely strong, simple painkillers such as dipyrone, paracetamol and the like do not tickle!
Codeine, tramadol and even morphine are usually used, but it is very common to need to go to the emergency room in order to improve the crisis.
Avoiding pain is fundamental in treatment. Prophylaxis takes place through various drugs, also used in other neurological diseases, such as anticonvulsants (carbamazepine, gabapentin, phenytoin, pregabalin); antidepressants (amitriptyline, nortriptyline), and also botulinum toxin (botox/dysport).
As there are many possible origins, it should be investigated and treated whenever found.
Neurovascular conflicts and tumors are usually resolved with a surgical approach. Multiple sclerosis and other demyelinating diseases also have specific treatment.
It is essential that the treatment is done correctly, with the medicines taken regularly and the proper follow-up with the specialist. It is common to have to change, associate or replace medications throughout the treatment.
Long periods of remission are very common, in which the patient is pain free for a long time, even without treatment. This may give the appearance of healing, and the patient may be left without adequate follow-up. Soon after, there may be a return of pain leading to great disability. Therefore, follow-up after diagnosis, even in the absence of pain, is very important.
Look for the expert!
Whenever there are symptoms of pain in the face, headache or unexplained pain, the neurologist is the specialist most indicated.
Delay in diagnosis leads to delay in treatment and resolution of the problem.
