3.5.3
Trigeminal Neuralgia
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 3, Central Nervous System Conditions.
Clinical Description
Severe, very short-lived stabs of facial pain in the sensory trigeminal distribution. It is important in the diagnostic workup to exclude intracranial mass lesions, which may impinge on the trigeminal nerve.
Pharmacological
- Carbamazepine, oral, 100 mg q8-12h, initial dose. Increase dose slowly. Doses of up to 1, 200 mg q24h may be required. After exacerbation, reduce to maintenance dose of 400-800 mg q24h.
Complications and Referral Criteria
For neuroimaging with MRI.
- If there is poor response to single drug therapy.
- Refer to Medical Rehabilitation Services for desensitization.
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