New treatments for trigeminal neuralgia

MBBS
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Trigeminal neuralgia(TN) is a disorder characterised by severe pain, over bursts of short duration, in the part of the face supplied by the trigeminal nerve such as the forehead, eye, cheek and jaw on the affected side. It may be a primary disorder or in many cases associated with MS (multiple sclerosis).

It is usually treated by drugs like carbamazepine and oxcarbazepine. Some surgical methods of treatment include procedures like microvascular decompress.

Recently, the use of botulinum toxin has proved useful in managing the symptoms of TN. In a study done in 2024, researchers found that botulinum toxin (more specifically botulinum toxin type A ie. BoNT-A) was useful in bringing about significant pain relief and less frequent recurrence.

What other such newer treatments have you read about recently?

MBH/PS

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Thanks for the update mam .It’s really informative.Along with oxcarbazepine and carbamazepine ,my assistant professor used to advise baclofen too(to reduce the pain )

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BoNT-A is a promising advance! I’ve also read about neuromodulation and gene therapy approaches showing potential in managing trigeminal neuralgia.

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Newer treatments for trigeminal neuralgia include:

  • Selective sodium channel blockers and second-line anticonvulsants (vixotrigine, lacosamide) for drug-resistant cases.
  • Topical nerve stabilizers for local relief.
  • Minimally invasive procedures like pulsed radiofrequency ablation, endoscopic decompression, and stereotactic radiosurgery.
  • Biological treatments such as platelet-rich plasma injections.
  • Neuromodulation devices and neuroplasticity-based rehabilitation approaches.
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Trigeminal neuralgia (TN) causes severe facial pain, traditionally treated with medications like carbamazepine or surgical options such as microvascular decompression. Recent advances show promise with newer therapies. Botulinum toxin type A (BoNT-A) has demonstrated significant pain relief and reduced recurrences. Emerging treatments include minimally invasive radiofrequency ablation devices, neuromodulation techniques like trigeminal ganglion stimulation, and non-invasive brain stimulation (tDCS, rTMS). Genetic research is exploring ion channel mutations for personalized therapies. Although many approaches are experimental, they offer hope for better management of TN’s debilitating pain, highlighting ongoing progress in understanding and treating this challenging disorder.