Trigeminal Neuralgia

[oyabun]

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Is anyone out there implanting morphine pumps for patients with trigeminal neuralgia who are refractory to narcotics and interventional procedures? If so, what level is the catheter? Thanks.

 

[mpp]

Morphine pumps are not a standard treatment for trigeminal neuralgia although it has been done experimentally (http://www.ncbi.nlm.nih.gov/entrez/...ids=12048422&query_hl=26&itool=pubmed_docsum).

The pain from trigeminal neuralgia is modulated through the trigeminal nerve, i.e. cranial nerve V, and therefore there is no 'level' for the catheter to be placed but rather it would be placed more like a peripheral nerve block in the face near the nerve branch outside of the cranium.

There are several other successful methods for treatment of trigeminal neuralgia both medical and surgical.

 

[Smilemaker100]

Morphine pumps are not a standard treatment for trigeminal neuralgia although it has been done experimentally (http://www.ncbi.nlm.nih.gov/entrez/...ids=12048422&query_hl=26&itool=pubmed_docsum).

The pain from trigeminal neuralgia is modulated through the trigeminal nerve, i.e. cranial nerve V, and therefore there is no 'level' for the catheter to be placed but rather it would be placed more like a peripheral nerve block in the face near the nerve branch outside of the cranium.

There are several other successful methods for treatment of trigeminal neuralgia both medical and surgical.

Interesting topic.

From what I understand, carbamazepine is the "gold standard" for the management of trigeminal neuralgia before considering surgical alternatives.

 

[PICA]

Interesting topic.

From what I understand, carbamazepine is the "gold standard" for the management of trigeminal neuralgia before considering surgical alternatives.

Carbamazepine is a good medical choice. I think about 80% get some improvement. Glycerol infusions at or near the root entry zone can be easy and quick outpatient procedures and are being done for medically refractory cases.