@entity4254 is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of @entity158 within the distribution of one or more branches of the trigeminal nerve, which has a profound effect on quality of life. The diagnosis is made on history alone, and time needs to be taken to elicit the key features and differentiate from toothache or one of the trigeminal autonomic @entity10 . Most @entity4254 is idiopathic, but a small percentage is due to secondary causes-for example, @entity5 or @entity15 -which can be picked up on CT or MRI. Recently published international guidelines suggest that @entity2049 and @entity2051 are the first-line drugs. There is limited evidence for the use of @entity2812 and @entity1772 . If there is a decrease in efficacy or tolerability of medication, surgery needs to be considered. A neurosurgical opinion should be sought early. There are several ablative, destructive procedures that can be carried out either at the level of the Gasserian ganglion or in the posterior fossa. The only non-destructive procedure is microvascular decompression (MVD). The ablative procedures give a 50% chance of @entity1 being @entity158 free for 4 years, compared with 70% of @entity1 at 10 years after MVD. Ablative procedures result in sensory loss, and MVD carries a 0.2-0.4% risk of mortality with a 2-4% chance of ipsilateral @entity393 . Surgical procedures result in markedly improved quality of life. @entity1 support groups provide information and support to those in @entity158 and play a crucial role.

@entity4254 : the diagnosis and management of this excruciating and poorly understood XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'Patient'] @entity2812 :: ('MESH:C047781', 'Chemical') :: ['lamotrigine'] @entity2051 :: ('MESH:C036006', 'Chemical') :: ['oxcarbazepine'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumours'] @entity4254 :: ('MESH:D014277', 'Disease') :: ['Trigeminal neuralgia', 'trigeminal neuralgia'] @entity2049 :: ('MESH:D002220', 'Chemical') :: ['carbamazepine'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity393 :: ('MESH:D034381', 'Disease') :: ['hearing loss'] @entity10 :: ('MESH:D006261', 'Disease') :: ['cephalalgias'] @entity1772 :: ('MESH:D001418', 'Chemical') :: ['baclofen'] @entity15 :: ('MESH:D009103', 'Disease') :: ['multiple sclerosis']
@entity158 :: (MESH:D010146,Disease) :: ['facial pain']
