When Your Head Hurts: Trigeminal And Occipital Neuralgia

Treatments for occipital neuralgia and trigeminal neuralgia

Many treatments focus on pain management, although there are surgical treatments that can possibly provide more lasting relief.

If the pain from trigeminal or occipital neuralgia isn’t too severe, it might be worth trying some home therapies to find relief. Rest in a quiet room, a neck massage, or the application of heat might help. Over-the-counter pain medications, like Advil or Tylenol, might also alleviate symptoms.

Controlling facial pain with current medical and surgical treatments is known to be very difficult, but may be helpful for people who don’t respond to more conservative treatments. The standard medical approaches are anti-inflammatory, anticonvulsant, and antidepressant medications.

After these fail, local anesthetic blocks are attempted, but only provide temporary pain relief. Lastly, percutaneous or open procedures may be done, or even more rarely, neurostimulation. However, peripheral nerve stimulation may be a viable option earlier in the treatment of chronic facial pain.


Medications for occipital and trigeminal neuralgia

Medical treatment is usually the first-line therapy. Carbamazepine is the most effective and usually has manageable side effects. If it is ineffective or not tolerated, then combination with gabapentin, phenytoin, baclofen, lamotrigine, topiramate, or tizanidine may be beneficial.

It is recommended to periodically taper the medications down in patients experiencing pain relief in order to check for the occasional permanent remission.


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<strong>Interventional pain management</strong>
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