Trigeminal neuralgia and its management

A recent clinical review on the management of trigeminal neuralgia discusses prevalence and diagnosis through to drug and surgical treatment options.Trigeminal neuralgia is a severe unilateral paroxysmal facial pain, often described by patients as the "the world's worst pain," writes Dr Geraint Fuller (Gloucester Royal Hospital, UK) and colleagues in the BMJ. The condition responds poorly to analgesics, say the authors, but when recognized it can be treated. The pathophysiology of trigeminal neuralgia is becoming clearer. A wide range of medical and surgical treatments has been developed and introduced usually without randomized controlled trials. As a result, uncertainty remains about how best to use the available treatments, they write. In summary Fuller's group note:Most cases are referred to as idiopathic, although many are associated with vascular compression of the trigeminal nerve;...