There are two different theories as to the cause of trigeminal neuralgia. A peripheral cause may be due to compression of the nerve by a vein or artery. Surgical decompression has been a successful treatment in some cases. Compression of the nerve by a tumor may occur in a few cases. As of March 1999, treatment for both pretrigeminal neuralgia and trigeminal neuralgia are essentially the same.
Drug therapy can also help differentiate trigeminal neuralgia from toothache pain.
The typical drugs used the treat trigeminal neuralgia are called membrane stabilizing drugs. Trigeminal neuralgia typically responds to these drugs, whereas toothache pain does not. Commonly used drugs include baclofen, carbamazepine, and phenytoin. When neither baclofen or carbamazepine are effective alone, they can be used together. Due to drug side effects, these drugs should be used carefully, and closely monitored for their effectiveness.