Management of trigeminal neuralgia (tic douloureux)
R. Voorhies and R. H. Patterson
The initial treatment of trigeminal neuralgia is accomplished with drugs,
primarily carbamazepine and occasionally phenytoin sodium. However, many
patients become refractory to treatment or side effects develop such as
drowsiness or ataxia. In these circumstances, surgical therapy is
appropriate. At our institution, microsurgical decompression has yielded
good to excellent results in 29 of 32 patients and is currently recommended
for persons in good general health who are younger than 70 years. Because
of the notable incidence of unpleasant dysesthesias in the face,
percutaneous radiofrequency rhizotomy is reserved for persons whose age or
general medical condition precludes craniotomy.
