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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 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 • Alternative Treatments for TN • Resources, On-Line and Off
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
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 • 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 • 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 • Use of templates in Gamma Knife focus • Use of Endoscopes in DMV exploration • Deep Brain Stimulation (Janetta)
Research on Alternative Treatments • Magnets in treatment of Sciatica (trials)
Carbamazepine (Tegretol) Gabapentin (Neurontin) Baclofen Clonozepam Lamotrigin Oxcarbamazepine Phenytoin Review of Treatments – Medical • Amitriptyline • Nortriptyline (Pamelor) • Protriptyline • Sumatriptan (cluster headaches) • NSAIDS / Opoids • Capsaisin (topical)
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)
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 • 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