Cited by 726Trigeminal Neuralgia and TreatmentsTemporomandibular Joint DisordersPain Management and Treatment

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AAN-EFNS guidelines on trigeminal neuralgia management

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Cruccu, G., Gronseth, G., Alksne, J., Argoff, C., Brainin, M., Burchiel, K., Nurmikko, T., Zakrzewska, J. M.·2008·European Journal of Neurology

DOI 10.1111/j.1468-1331.2008.02185.x

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Abstract

Several issues regarding diagnosis, pharmacological treatment, and surgical treatment of trigeminal neuralgia (TN) are still unsettled. The American Academy of Neurology and the European Federation of Neurological Societies launched a joint Task Force to prepare general guidelines for the management of this condition. After systematic review of the literature the Task Force came to a series of evidence‐based recommendations. In patients with TN MRI may be considered to identify patients with structural causes. The presence of trigeminal sensory deficits, bilateral involvement, and abnormal trigeminal reflexes should be considered useful to disclose symptomatic TN, whereas younger age of onset, involvement of the first division, unresponsiveness to treatment and abnormal trigeminal evoked potentials are not useful in distinguishing symptomatic from classic TN. Carbamazepine (stronger evidence) or oxcarbazepine (better tolerability) should be offered as first‐line treatment for pain control. For patients with TN refractory to medical therapy early surgical therapy may be considered. Gasserian ganglion percutaneous techniques, gamma knife and microvascular decompression may be considered. Microvascular decompression may be considered over other surgical techniques to provide the longest duration of pain freedom. The role of surgery versus pharmacotherapy in the management of TN in patients with multiple sclerosis remains uncertain.

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Authors: Cruccu, G., Gronseth, G., Alksne, J., Argoff, C., Brainin, M., Burchiel, K., Nurmikko, T., & Zakrzewska, J. M.
Affiliations: Sapienza University of Rome (IT)
University of Kansas (US)
University of California San Diego (US)
North Shore University Hospital (US)
Universität für Weiterbildung Krems (AT)
Oregon Health & Science University (US)
University of Liverpool (GB)
Eastman Dental Hospital (GB)
Corresponding author: Cruccu, G.
ORCID: Cruccu, G.
Gronseth, G.
Argoff, C.
Brainin, M.
Burchiel, K.
Nurmikko, T.
Zakrzewska, J. M.
Venue: European Journal of Neurology
Publisher: Wiley
Published: 2008-09-05
Volume: 15
Issue: 10
Pages: 1013-1028
ISSN: 1351-5101 (ISSN-L)
1468-1331
DOI: 10.1111/j.1468-1331.2008.02185.x
OpenAlex: W2066791546
Cited by: 726
References: 92
Citations by year: 2026: 20 · 2025: 27 · 2024: 41 · 2023: 49 · 2022: 51 · 2021: 55 · 2020: 54 · 2019: 58 · 2018: 51 · 2017: 52 · 2016: 40 · 2015: 38 · 2014: 47 · 2013: 32 · 2012: 29
FWCI: 19.16
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: European Journal of Neurology (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › Trigeminal Neuralgia and Treatments
Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: trigeminal neuralgia, diagnosis, carbamazepine, oxcarbazepine, microvascular decompression, gamma knife radiosurgery, surgical treatment, refractory trigeminal neuralgia, multiple sclerosis, trigeminal evoked potentials, pain management
MeSH terms: Oxcarbazepine, Adolescent, Adult, Aged, Aged, 80 and over, Analgesics, Anticonvulsants, Carbamazepine, Child, Child, Preschool, Combined Modality Therapy, Diagnostic Imaging, Double-Blind Method, Female, Humans, Male, Middle Aged, Trigeminal Ganglion, Sensitivity and Specificity, Trigeminal Neuralgia, Randomized Controlled Trials as Topic, Radiosurgery, Decompression, Surgical, Evidence-Based Medicine, Disease Management

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