Trigeminal neuralgia
- Carbamazepine or oxcarbazepine first-line
- Titrate to pain freedom if tolerated
- Check sodium/CBC/liver effects as appropriate
- MRI if atypical features/secondary-cause concern
- Baclofen/lamotrigine can be adjuncts
- Refractory classic disease → surgical evaluation
- Opioids usually work poorly
Use at a glance
- Carbamazepine or oxcarbazepine first-line
Escalation / refractory disease
- Refractory classic disease → surgical evaluation
Practical pearls
- Baclofen/lamotrigine can be adjuncts
- Opioids usually work poorly
Choosing treatment
- Titrate to pain freedom if tolerated
- MRI if atypical features/secondary-cause concern
Other practical pearls
- Check sodium/CBC/liver effects as appropriate
Self-check
- What should be checked in Trigeminal neuralgia?
sodium/CBC/liver effects as appropriate.
- What is first-line treatment for Trigeminal neuralgia?
Carbamazepine or oxcarbazepine.
Drugs used for this (2)
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