Management of trigeminal neuralgia

Trigeminal neuralgia is a common and disabling condition. It is easily diagnosed with a carefully elicited history. The presence of any neurological signs should alert the doctor to other diagnoses. Medical management with carbamazepine should be offered initially to all patients. Second-line therapies are available but are only rarely of use. A variety of surgical therapies are available and should be offered to the patient when medical therapy fails. Therapy should cater to each individual, and the patient's wishes should remain paramount.