Trigeminal Neuralgia Guidelines

Updated: Jul 11, 2019
  • Author: Manish K Singh, MD; Chief Editor: Robert A Egan, MD  more...
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Guidelines

Guidelines Summary

European Academy of Neurology

In 2019, the European Academy of Neurology (EAN) developed guidelines for daily clinical management of patients with trigeminal neuralgia (TN). [66] Recommendations include the following:

  •  all TN patients should undergo MRI

  • carbamazepine and oxcarbazepine should be used as first-line prophylactic treatments of TN

  • lamotrigine, gabapentin, botulinum toxin type A, pregabalin, baclofen, and phenytoin may be used either alone or as add-on therapy

  • patients should be offered surgery if pain is not sufficiently controlled medically or if medical treatment is poorly tolerated

  • in patients with classical TN, microvascular decompression is recommended as first-line surgery