Diagnosis and Treatment of Patients with Trigeminal Neuralgia: A Review

Abstract

Trigeminal neuralgia (TN) is one of the most common forms of neuropathic pain found in the head and neck region, the diagnosis of which is clinical. Long-term oral medication offers no benefits for patients with TN. Interventions for these patients include percutaneous rhizotomy, radiofrequency thermocoagulation, balloon compression, botulinum neurotoxin, stereotactic Gamma knife radiosurgery and microvascular decompression. The aim of the present study was to investigate aspects of the diagnosis and treatment of patients with trigeminal neuralgia through a literature review. A bibliographic survey was conducted through searches of the SciELO, BIREME, Medline and Google Scholar electronic databases for relevant articles published in the English language. The articles found in the literature were divided into four groups: Group 1definition and epidemiology (references 1 to 9); Group 2diagnosis (references 10 to 12), Group 3: treatment (references 13 to 26); Group 4: interventional approaches (references 27 to 40). TN is one of the most common forms of neuropathic pain found in the head and neck region. The diagnosis is based on a history of pain such as an "electrical shock" felt in a division of the trigeminal nerve. Approximately 50% of patients with TN do not achieve long-term benefits from drug therapy. Interventional approaches require more scientific research. Future studies should focus on genetics, unexplored etiological factors, sensory function, neurosurgical outcomes and complications, combinations and neuromodulation as well as the development of new drugs with greater tolerability.