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The Most Effective Treatment For Trigeminal Neuralgia.

28th December, 2009 - Posted by health news - No Comments

It has been reported on the effectiveness of serotonin reuptake inhibitors and norepinephrine (SNRIs) Effexor, so as Cymbalta.
A small group of patients with combined pathology may receive reuptake inhibitors, norepinephrine and dopamine (NDRIs) type of bupropion (Wellbutrin).

Isolated reports of researchers are devoted to the efficiency of reuptake inhibitors and receptor blockers, trazodone (Desyrel), nefazodone (Serzone), Maprotiline and Remeron.

Vasoactive drugs (such as trental, cavinton etc.) are used for intermittent claudication, vascular dementia, sickle cell anemia. Its application for trigeminal neuralgia is thought to be controversial regarding to the mechanism and evidence base.

In order to reduce the activity of “triggers” zones in the acute stage of the disease local anesthetics such as lidocaine, trimekain, chloroethyl were really used many years ago. Its efficiency is not high, the availability of chloroethyl and preparations of local anesthetics, which are able to act through the intact skin, is limited.

We should also mention the interventions. Some authors recommend such efferent methods of therapy as plasmapheresis and hemosorbtion. But there is no clear understanding of both therapeutic mechanism, which is being tried to be implemented by the authors, and statistics. Methods are not accepted for use concerning trigeminal neuralgia.

Surgical decompression can be conducted when there is a detection of vascular or neoplastic changes.
Blockades by alcohol and glycerol carry higher risks of complications, including adhesive processes and recurrence of pain.

Percutaneous balloon micro-compression has the same risks and the frequency of relapses, as well as the blockades with alcohol and glycerol.
Radio surgery with gamma knife using is very expensive procedure, which has no advantages over radiofrequency of the trigeminal nerve site` Gasserov rhizotomy. Long term results of gamma-radiation treatment of the nervous system and skull tissues with non-oncological diseases, is under study now.

Cryodestruction is an old technique, which is rarely used because of the relative short-term effect and because it is a traumatic method (there is relatively thick cryoprobe).

The most effective and safe treatment for trigeminal neuralgia is a method of radiofrequency destruction of the trigeminal nerve root. The main advantage of the method of radiofrequency thermal destruction is that the size of the zone of destruction can be adequately followed up, and electrode with temperature sensor registers a temperature in the zone of destruction. It is possible to set the exact time of impact. And the control of electrical stimulation and the level of resistance make it possible to install the electrode correctly and accurately. Using local anesthesia provides a short recovery period and if necessary, may repeat passages of radiofrequency thermal, although it is rarely conducted. The level of success for radiofrequency thermal destruction is up to 98%. Occasionally reducing of the corneal (blink) reflex of effects side and transient weakness of chewing muscles may occur. The recovery lasts independently during several months and requires no special intervention.

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