How do you manage acute exacerbations of trigeminal neuralgia?
What effective modalities have you found for acute exacerbations of trigeminal neuralgia including in patients who present to the ED?
Answer from: at Community Practice
I do not have personal experience treating TN exacerbations in the ED. What is generally recommended under those circumstances is intravenous phenytoin. Schnell et al. recently published it in The Journal of Headache and Face Pain (Schnell et al., PMID 32981076). They published the results of a retr...
Auricotemporal Nerve Blocks and more
Extra dose of medication patient is taking:
Baclofen
Diazepam
Nurtec off label use
Steroids Taper
If there is high blood pressure, BP medication is given to reduce the pulse pressure of the vascular loop.
Two new studies out support the following treatments:
IV fosphenytoin Andersen et al., PMID 35469443
IV lacosamide or IV Phenytoin Muñoz-Vendrell et al., PMID 35469475
Comments
at UF Health Definitely, IV Fosphenytoin but most of the time y...