Treatment of Neuropathic Trigeminal Pain

The recent international guidelines on management of trigeminal neuralgia suggest that canthama/epime and oxcabaxepine should be the first line drugs used. Surgery provides longer-term relief especially microvascular decompression but there is a lack of high quality evidence to support this. Patient support groups provide a means by which patients can meet each other and healthcare processionals with an interest in trigeminal neuralgia. Trigeminal neuropathic pain and its variant atypical odontalgia are managed as other neuropathic pains with tricyclic antidepressants in the first instance and then using progabalin or gabapeutin. Traumatic injuries of the trigeminal nerve can in some instances be treated by early microsurgery. Burning mouth syndrome a form of neuropathic pain responds to cognitive behaviour therapy and topical clonazepam.