Trigeminal Neuralgia.

Area of Science:

• Neurology
• Neurosurgery

Background:

• Trigeminal neuralgia (TN) presents as sudden, severe facial pain, with Type 1 (intermittent) and Type 2 (constant) representing distinct clinical entities.
• While various mechanisms are implicated, neurovascular conflict (NVC) is the leading theory for TN etiology.
• Diagnosis is primarily clinical, supported by MRI to identify NVC and rule out secondary causes.

Purpose of the Study:

• To review the clinical presentation, diagnostic methods, and therapeutic strategies for trigeminal neuralgia.
• To highlight the role of neurovascular conflict as the primary cause and discuss management options.

Main Methods:

• Literature review of trigeminal neuralgia diagnosis and treatment.
• Analysis of medical and surgical interventions, including pharmacological and procedural options.

Main Results:

• Carbamazepine is the first-line pharmacotherapy; other medications include oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate.
• Microvascular decompression is the preferred surgical treatment for medically refractory TN.
• Alternative procedures like radiosurgery and percutaneous techniques are options for specific patient groups, while endoscopic approaches offer enhanced visualization during surgery.

Conclusions:

• Effective management of trigeminal neuralgia involves a stepwise approach, starting with medication and progressing to surgical interventions when necessary.
• Advanced techniques like endoscopy improve surgical outcomes by providing superior visualization of neurovascular compression.
• Multidisciplinary and individualized treatment plans are crucial for managing this debilitating condition.