title: Trigeminal neuralgia (tic douloureux).
abstract: Trigeminal neuralgia is not common, but is a debilitating pain syndrome. After the diagnosis is established, a stepwise approach to treatment is recommended. Carbamazepine is the drug of choice. When carbamazepine fails to relieve pain, baclofen and then phenytoin are used. A number of second-line drugs, such as clonazepam, divalproex sodium, chlorphenesine carbamate, and pimozide can also be tried. A large number of patients will respond to one or another drug or to a combination of two drugs. When medical treatment fails, several surgical procedures have been found to be effective. Percutaneous radiofrequency gangliolysis is the most widely used procedure with a high success rate. All surgical procedures must be performed by an experienced physician in order to achieve the lowest possible rate of serious complications.
authors.forename: A
authors.initials: A
authors.lastname: Mauskop
mesh_terms: D001418:Baclofen / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D010672:Phenytoin / Q000627:therapeutic use; D014277:Trigeminal Neuralgia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery
chemical_list: D002220:Carbamazepine; D010672:Phenytoin; D001418:Baclofen