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Research for Options in Treating Trigeminal Neuralgia. R.A. “Red” Lawhern, Ph.D. Webmaster – TNA Homepage – 1998-2001. Outline. Types of Face Pain Disorders Trends in Visibility for Face Pain Recent Research General Pain Research Medications for TN Surgery for TN

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research for options in treating trigeminal neuralgia

Research for Options in Treating Trigeminal Neuralgia

R.A. “Red” Lawhern, Ph.D.

Webmaster – TNA Homepage – 1998-2001

outline
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
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”

Face Pain Disorders
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

Trends in Visibility 1996-2003

2003

1996

trends in pain research
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
research on medical treatment
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)
research on surgery
Research on Surgery
  • Use of templates in Gamma Knife focus
  • Use of Endoscopes in DMV exploration
  • Deep Brain Stimulation (Janetta)
research on alternative treatments
Research on Alternative Treatments
  • Magnets in treatment of Sciatica (trials)
review of treatments medical
Carbamazepine (Tegretol)

Gabapentin (Neurontin)

Baclofen

Clonozepam

Lamotrigin

Oxcarbamazepine

Phenytoin

Review of Treatments – Medical
  • Amitriptyline
  • Nortriptyline (Pamelor)
  • Protriptyline
  • Sumatriptan (cluster headaches)
  • NSAIDS / Opoids
  • Capsaisin (topical)
review of treatments surgical
MVD

Radio Frequency Rhizotomy

Balloon Compression

Glycerol Rhizotomy

Gamma Knife Radiosurgery

Review of Treatments – Surgical
  • Nerve Blocks
  • Neurotomy
  • NICO Surgery
  • DREZ (Dorsal Root Entry Zone)
review of treatments alternative
Acupuncture

Ayurvedic Medicine

Botulinum Toxin (Botox)

Capsaisin

Cervical Chiropractic

Exercise / Running

Homeopathy

Hot / Cold Compresses

Review of Treatments - Alternative
  • Hypnosis
  • Low Intensity Laser
  • Lidocaine Cream / Patch
  • Myotherapy
  • Osteopathy
  • TENS (Postherpetic N.)
  • Vitamin B12
  • Yoga / Biofeedback
doing your own info research
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