BMJ  2007;334:201-205 (27 January), doi:10.1136/bmj.39085.614792.BE

Clinical Review

Trigeminal neuralgia and its management

Luke Bennetto, honorary clinical research fellow1, Nikunj K Patel, consultant neurosurgeon2, Geraint Fuller, consultant neurologist3

1 Institute of Clinical Neurosciences, University of Bristol, Frenchay Hospital, Bristol BS16 1LE, 2 Department of Neurosurgery, Frenchay Hospital, 3 Gloucester Royal Hospital, Gloucester GL1 3NN

Correspondence to: G Fuller geraint.fuller@glos.nhs.uk

The first 150 words of the full text of this article appear below.

Trigeminal neuralgia is a severe unilateral paroxysmal facial pain, often described by patients as the "the world's worst pain."


Trigeminal neuralgia is a rare but characteristic pain syndrome
Most cases are still referred to as idiopathic, although many are associated with vascular compression of the trigeminal nerve
A minority of cases are symptomatic of multiple sclerosis or nerve compression by tumour
The condition is variable and patients may have just one episode
Most patients respond well to drugs; carbamazepine is usually the first line treatment
If drug treatment fails or is not tolerated, surgical treatments are available
Ablative surgical treatments are associated with facial sensory loss, almost no risk of severe complications or death, and a high rate of pain recurrence; microvascular decompression has a risk of severe complications or death, albeit very low, and a lower relapse rate


The diagnosis is made by general practitioners in 27 per 100 . . . [Full text of this article]


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This article has been cited by other articles:

  • Watson, J. C. (2007). From paroxysmal to chronic pain in trigeminal neuralgia: Implications of central sensitization. Neurology 69: 817-818 [Full text]  

Rapid Responses:

Read all Rapid Responses

Peripheral Surgery is still an imortant option in the management of Trigeminal Neuralgia
Niall M H McLeod
bmj.com, 31 Jan 2007 [Full text]
High quality studies are required to verify the role of all surgical treatments in trigeminal neuralgia
Luke Bennetto, et al.
bmj.com, 11 Feb 2007 [Full text]
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