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Updated: Jun 21, 2026
09:35
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
1. Trigeminal neuralgia
Maarten van Kleef1, Wilco E van Genderen, Sem Narouze
1Department of Anesthesiology and Pain Management, Maastricht University Medical Centre, Maastricht, The Netherlands. maarten.van.kleef@mumc.nl
Summary
This review offers evidence-based recommendations for managing trigeminal neuralgia (TN), a condition causing severe facial pain. It outlines multidisciplinary treatment options, prioritizing carbamazepine or oxcarbazepine, with surgical interventions like microvascular decompression or radiofrequency treatment for specific patient groups.
Area of Science:
- Neurology
- Pain Management
- Evidence-Based Medicine
Background:
- Trigeminal neuralgia (TN) is a prevalent neurological disorder characterized by intense facial pain.
- TN significantly impairs patients' quality of life and socioeconomic functioning.
- Current management strategies require updated, evidence-based recommendations.
Purpose of the Study:
- To provide comprehensive recommendations for the medical management of trigeminal neuralgia.
- To synthesize current evidence and clinical experience for TN treatment.
- To present a clinical practice algorithm for TN pain management.
Main Methods:
- Systematic literature review and analysis of existing studies on trigeminal neuralgia.
- Integration of clinical experience in pain management, assessment, and diagnosis.
- Development of a clinical practice algorithm based on evidence and expert consensus.
Main Results:
- Carbamazepine or oxcarbazepine are identified as first-line pharmacological treatments for trigeminal neuralgia.
- Microvascular decompression is recommended as the primary invasive treatment for younger patients.
- Radiofrequency treatment of the Gasserian ganglion is suggested for elderly patients, with detailed technique description.
Conclusions:
- Multidisciplinary treatment approaches are essential for effective trigeminal neuralgia management.
- Informed patient discussion regarding various treatment options and associated risks is crucial.
- The review provides a structured algorithm to guide clinical decision-making in trigeminal neuralgia treatment.
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