How is trigeminal neuralgia treated?
Trigeminal neuralgia can be treated in many different ways. As with many disorders, some treatments will work well for some people and less so for others. Don’t get discouraged if the first treatment you try doesn’t work. Let your doctor know how you are doing and ask about other options.
Your doctor may prescribe an anticonvulsant, antiseizure or antispasmodic drug. These medicines change how nerves transmit information, or how the nerves “fire.” That is why they can help with the pain caused by trigeminal neuralgia. Examples of these medicines include baclofen, carbamazepine, clonazepam, gabapentin, lamotrigine, oxcarbazepine, phenytoin, topiramate and valproic acid.
Certain types of antidepressants can also be useful in the treatment of pain associated with trigeminal neuralgia. Antidepressants alter the chemical action in your brain that leads to sensing pain. Some examples include amitriptyline, paroxetine, fluoxetine, nortriptyline and some newer antidepressants.
Combinations of two or even three medications may be more effective than a single medication. Often, a lot of time is spent in trying different medications and combinations of medications to find the most effective medical treatment. Side effects, such as feeling tired, can limit the use of some of the medications.
Your doctor might suggest you try a nerve block, which is an injection with an anesthetic that will stop the nerve from hurting, at least for a little while.
If medicines do not help enough and the pain is affecting your ability to function, you may need surgery. During surgery, your doctor will damage or destroy certain nerves using chemicals, electric currents, radiation or other means. The trigeminal nerve itself might be cut to eliminate or reduce the pain. Any surgery in which nerves are destroyed will cause some ongoing numbness. However, sometimes, pain can return after surgery and be worse than before.
Written by familydoctor.org editorial staff