When the cause for trigeminal neuralgia is an inflammatory response, prescriptions for non-steroidal anti-inflammatory medications (NSAIDs), such as aspirin or naproxen, can be the first-line medical treatment. The use of these medications appears to be more effective in individuals who experience episodic migraines on ten days or less per month. NSAIDs may result in organ failure when they are used consistently over a long-term period of time. In higher doses, acetaminophen may also be credible in treating mild episodes of migraines that are associated with trigeminal neuralgia. However, taken regularly or in excess, acetaminophen can also cause liver failure.
In some patients, prescriptions for opioid drugs are used to control pain. These drugs trigger receptors in the spinal nerves in order to inhibit the transmission of pain signals. Usual types of opioids prescribed include fentenyl, codeine, and morphine. Although effective in some populations, they are related to a higher risk of drug tolerance and addiction. Individuals using opioids for the treatment of migraines may find a rebound effect occurs when they discontinue using them. This means the migraine symptoms can become much worse when the individual suddenly stops using the medication.
Carbamezapine may also be prescribed for intermittent migraines and is an anti-seizure medication. This medication has more significant side effects, including skin irritation, allergic reactions, and toxic epidermal necrolysis. Reactions of this type are found more frequently in native Asian individuals.
The trigeminal nerve splits into three divisions. These divisions unite into a single grouping situated behind the eyes. The group of nerves is called the semilunar ganglion or trigeminal Gasserian. In some cases, physicians may target this area using a minimally intrusive surgical treatment to reduce or completely relieve severe pain that has not responded to other more conservative treatments. One type of procedure used is radiofrequency ablation done with a thin probe introduced through the nose or mouth. A local numbing agent is injected prior to starting the procedure during which the ganglion is found using imaging technology. Fluoroscopy or magnetic resonance imaging is used to locate the area, while the probe is inserted and electro-thermal impulses are discharged, which selectively eliminates the nerve tissue accountable for the signals of pain.
Radiofrequency ablation results in immediate pain relief in close to 97% of patients suffering from migraines. The risks related to this procedure are infection, the potential for reduced sensation or motor control in the facial area, and discomfort with the insertion of the probe. Even with local anesthesia, some individuals may experience extreme pain with the insertion of the surgical probe.
Trigeminal neuralgia is a disorder of the trigeminal nerves that causes extreme pain. Treatment may include opioids and non-steroidal anti-inflammatory medications. If these treatments fail to bring about sufficient pain relief, other more invasive surgical procedures may be considered by the physician to achieve effective and long-term pain relief. One such procedure is the radiofrequency ablation. During this procedure electro-thermal impulses are used to destroy the region of the trigeminal ganglion that is responsible for transmitting pain signals to the brain. This particular technique has reported results up to 97% success rate.
Global Neuro & Spine Institute physicians are double and triple-board certified, fellowship trained, and remain on the cutting edge of technology. In our practice, we use the most advanced techniques and the highest standards to develop an individualized and comprehensive treatment plan for each of our patients. We are also very proud of our policy to place great importance on educating those we treat, while addressing any questions or concerns that may exist.
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