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Research for Options in Treating Trigeminal Neuralgia

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Research for Options in Treating Trigeminal Neuralgia

  1. 1. Research for Options in Treating Trigeminal Neuralgia R.A. “Red” Lawhern, Ph.D. Webmaster – TNA Homepage – 1998-2001
  2. 2. Outline • Types of Face Pain Disorders • Trends in Visibility for Face Pain • Recent Research – General Pain Research – Medications for TN – Surgery for TN – Alternative Treatments for TN • Resources, On-Line and Off
  3. 3. Face Pain Disorders • Trigeminal Neuralgia – Typical, Atypical • Glossopharyngeal Neuralgia • Postherpetic Neuralgia • Geniculate Neuralgia • Vegal / Superior Laryngeal Neuralgia • Occipital Neuralgia • “MS-related” face pain • Cluster headache • Fibromyalgia • Anesthesia Dolorosa • Atypical Odontalgia • Hemi-facial spasm • NICO • TMJ • Facial Tendonitis • Sinusitis, Dental Problems • “Atypical Facial Pain Syndrome”
  4. 4. Trends in Visibility 1996-2003 • TN Hits at Google: 24,500 • ATN at Google: 475 • GN at Google: 165 • TN Abstracts at Pub Med: ~3600 • TN Hits at Google: ~1800 • ATN at Google <100 • GN at Google: <30 • TN Abstracts at Pub Med: <1000 19962003
  5. 5. Trends in Pain Research • Medical profession has finally discovered pain – More articles about under-treatment, standards – More research on CNS neurologic pain • Primarily neuralgia, spinal and cancer pain • Increased public advocacy for new policies – Treatment on demand, not on “need” – Patient informed and participating – Multi-disciplinary pain management
  6. 6. Research on Medical Treatment • Studies of the adequacy of past trials • AC1 / AC8 Animal studies (January 03) – Proteins to suppress pain sensitivity • Neuro-peptide studies (OSU) • Anti-convulsants and Neuropathic Pain • Shingles prevention study (trials) • Topimirate – Antidepressant (experimental) • Valproic Acid (experimental)
  7. 7. Research on Surgery • Use of templates in Gamma Knife focus • Use of Endoscopes in DMV exploration • Deep Brain Stimulation (Janetta)
  8. 8. Research on Alternative Treatments • Magnets in treatment of Sciatica (trials)
  9. 9. Review of Treatments – Medical • Carbamazepine (Tegretol) • Gabapentin (Neurontin) • Baclofen • Clonozepam • Lamotrigin • Oxcarbamazepine • Phenytoin • Amitriptyline • Nortriptyline (Pamelor) • Protriptyline • Sumatriptan (cluster headaches) • NSAIDS / Opoids • Capsaisin (topical)
  10. 10. Review of Treatments – Surgical • MVD • Radio Frequency Rhizotomy • Balloon Compression • Glycerol Rhizotomy • Gamma Knife Radiosurgery • Nerve Blocks • Neurotomy • NICO Surgery • DREZ (Dorsal Root Entry Zone)
  11. 11. Review of Treatments - Alternative • Acupuncture • Ayurvedic Medicine • Botulinum Toxin (Botox) • Capsaisin • Cervical Chiropractic • Exercise / Running • Homeopathy • Hot / Cold Compresses • Hypnosis • Low Intensity Laser • Lidocaine Cream / Patch • Myotherapy • Osteopathy • TENS (Postherpetic N.) • Vitamin B12 • Yoga / Biofeedback
  12. 12. Doing Your Own Info Research • Striking Back – A Layman’s Guide to… – George Wiegel and Kenneth F. Casey M.D. • Trigeminal Neuralgia – Pathophysiology, Diagnosis and Current Treatment – British Journal of Anesthesia, 2001, Vol 87, No 1 (online) • TNA Homepage: http://www.tna-support.org • Facial Neuralgia Resources: http://facial-neuralgia.org • Google: http://www.google.com – Others: Altavista, Medline, Yahoo

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