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Title: New Guideline for Treating Trigeminal Neuralgia Now Includes Surgery
URL: http://www.pslgroup.com/dg/229966.htm
Doctor's Guide
August 21, 2008

ST. PAUL, Minn -- August 21, 2008 -- According to a new guideline developed by the American Academy of Neurology, surgery may be considered for people who suffer from extreme, electric shock-like pain in their face and do not respond well to drugs.

The guideline on treating trigeminal neuralgia is published in the August 20 online issue of Neurology.

"There are very few drugs with strong evidence of effectiveness in treating trigeminal neuralgia," said guideline author Gary Gronseth, MD, University of Kansas, Kansas City, Missouri.

"If people fail to respond to these drugs, physicians should not be reluctant to consider referring the patient for surgery. Often surgery is considered a last resort and patients suffer while the well-intentioned physician tries other medications with limited effectiveness."

The guideline recommends that carbamazepine be offered as a first-line treatment for patients with trigeminal neuralgia. Oxcarbazepine should also be considered.

"If patients don't respond well to carbamazepine or 1 or 2 other drugs, it is reasonable to consider surgery that targets the root of the trigeminal nerve," said Dr. Gronseth.

The guideline also recommends that physicians consider sending all patients with trigeminal neuralgia for magnetic resonance imaging (MRI) or trigeminal reflex testing since up to 15% of patients have an underlying structural cause of the disorder, such as a tumour.

SOURCE: American Academy of Neurology

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