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- W2922242162 abstract "Background and purpose Trigeminal neuralgia (TN) is an extremely painful condition which can be difficult to diagnose and treat. In Europe, TN patients are managed by many different specialities. Therefore, there is a great need for comprehensive European guidelines for the management of TN. The European Academy of Neurology asked an expert panel to develop recommendations for a series of questions that are essential for daily clinical management of patients with TN. Methods A systematic review of the literature was performed and recommendations was developed based on GRADE, where feasible; if not, a good practice statement was given. Results The use of the most recent classification system is recommended, which diagnoses TN as primary TN, either classical or idiopathic depending on the degree of neurovascular contact, or as secondary TN caused by pathology other than neurovascular contact. Magnetic resonance imaging (MRI), using a combination of three high‐resolution sequences, should be performed as part of the work‐up in TN patients, because no clinical characteristics can exclude secondary TN. If MRI is not possible, trigeminal reflexes can be used. Neurovascular contact plays an important role in primary TN, but demonstration of a neurovascular contact should not be used to confirm the diagnosis of TN. Rather, it may help to decide if and when a patient should be referred for microvascular decompression. In acute exacerbations of pain, intravenous infusion of fosphenytoin or lidocaine can be used. For long‐term treatment, carbamazepine or oxcarbazepine are recommended as drugs of first choice. Lamotrigine, gabapentin, botulinum toxin type A, pregabalin, baclofen and phenytoin may be used either alone or as add‐on therapy. It is recommended that patients should be offered surgery if pain is not sufficiently controlled medically or if medical treatment is poorly tolerated. Microvascular decompression is recommended as first‐line surgery in patients with classical TN. No recommendation can be given for choice between any neuroablative treatments or between them and microvascular decompression in patients with idiopathic TN. Neuroablative treatments should be the preferred choice if MRI does not demonstrate any neurovascular contact. Treatment for patients with secondary TN should in general follow the same principles as for primary TN. In addition to medical and surgical management, it is recommended that patients are offered psychological and nursing support. Conclusions Compared with previous TN guidelines, there are important changes regarding diagnosis and imaging. These allow better characterization of patients and help in decision making regarding the planning of medical and surgical management. Recommendations on pharmacological and surgical management have been updated. There is a great need for future research on all aspects of TN, including pathophysiology and management." @default.
- W2922242162 created "2019-03-22" @default.
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- W2922242162 date "2019-04-08" @default.
- W2922242162 modified "2023-10-17" @default.
- W2922242162 title "European Academy of Neurology guideline on trigeminal neuralgia" @default.
- W2922242162 cites W1525799076 @default.
- W2922242162 cites W1542056147 @default.
- W2922242162 cites W1542586527 @default.
- W2922242162 cites W1668044175 @default.
- W2922242162 cites W1679569903 @default.
- W2922242162 cites W1680379638 @default.
- W2922242162 cites W1827138870 @default.
- W2922242162 cites W188297413 @default.
- W2922242162 cites W1922116349 @default.
- W2922242162 cites W1926840797 @default.
- W2922242162 cites W1927948151 @default.
- W2922242162 cites W1957324712 @default.
- W2922242162 cites W1964525210 @default.
- W2922242162 cites W1972533952 @default.
- W2922242162 cites W1973662582 @default.
- W2922242162 cites W1979145649 @default.
- W2922242162 cites W1979976727 @default.
- W2922242162 cites W1980778842 @default.
- W2922242162 cites W1981024482 @default.
- W2922242162 cites W1982887727 @default.
- W2922242162 cites W2001123085 @default.
- W2922242162 cites W2001257231 @default.
- W2922242162 cites W2007007022 @default.
- W2922242162 cites W2010193373 @default.
- W2922242162 cites W2011434356 @default.
- W2922242162 cites W2018393437 @default.
- W2922242162 cites W2018779183 @default.
- W2922242162 cites W2022498602 @default.
- W2922242162 cites W2023236672 @default.
- W2922242162 cites W2024900532 @default.
- W2922242162 cites W2032651402 @default.
- W2922242162 cites W2032900648 @default.
- W2922242162 cites W2041953078 @default.
- W2922242162 cites W2043781780 @default.
- W2922242162 cites W2044980334 @default.
- W2922242162 cites W2048843186 @default.
- W2922242162 cites W2052963366 @default.
- W2922242162 cites W2054855127 @default.
- W2922242162 cites W2058654455 @default.
- W2922242162 cites W2059437240 @default.
- W2922242162 cites W2060186351 @default.
- W2922242162 cites W2062270592 @default.
- W2922242162 cites W2064305918 @default.
- W2922242162 cites W2066457912 @default.
- W2922242162 cites W2066791546 @default.
- W2922242162 cites W2067523098 @default.
- W2922242162 cites W2070026732 @default.
- W2922242162 cites W2073155722 @default.
- W2922242162 cites W2078813321 @default.
- W2922242162 cites W2088633452 @default.
- W2922242162 cites W2091796482 @default.
- W2922242162 cites W2092190804 @default.
- W2922242162 cites W2092504977 @default.
- W2922242162 cites W2092757254 @default.
- W2922242162 cites W2093830415 @default.
- W2922242162 cites W2097000999 @default.
- W2922242162 cites W2109109035 @default.
- W2922242162 cites W2111892123 @default.
- W2922242162 cites W2112383677 @default.
- W2922242162 cites W2116205754 @default.
- W2922242162 cites W2121913244 @default.
- W2922242162 cites W2125448536 @default.
- W2922242162 cites W2135244205 @default.
- W2922242162 cites W2136196509 @default.
- W2922242162 cites W2140367363 @default.
- W2922242162 cites W2144342372 @default.
- W2922242162 cites W2151772219 @default.
- W2922242162 cites W2153767222 @default.
- W2922242162 cites W2155221506 @default.
- W2922242162 cites W2156493342 @default.
- W2922242162 cites W2158684188 @default.
- W2922242162 cites W2159130282 @default.
- W2922242162 cites W2161972563 @default.
- W2922242162 cites W2162638563 @default.
- W2922242162 cites W2167119527 @default.
- W2922242162 cites W2169762867 @default.
- W2922242162 cites W2273826798 @default.
- W2922242162 cites W2300154459 @default.
- W2922242162 cites W2320185671 @default.