THERAPY AND PROPHYLAXIS OF NEURALGIAS OF THE FACE AND ATYPICAL FACIALPAIN - RECOMMENDATIONS OF THE GERMAN MIGRAINE AND HEADACHE SOCIETY

Neuralgias of the head and face are characterized by unilateral, flash -like episodes of most intense pain in the area of the trigeminal, glo ssopharyngeal or intermediate nerve. Pain can be triggered by sensory stimuli. The pain during the acute attack does not respond to analgesi c medication (apart from opiates). Prophylaxis is performed with antie pileptic drugs like carbamazepine or phenytoine. Baclofen and neurolep tics are less effective and should be given only as add-pn medication. Patients, who do not respond to medical treatment should be operated, either by transcutaneous thermocoagulation of the ganglion or by micr ovascular decompression of the nerve. Atypical facial pain is characte rized by a dull and diffuse unilateral pain in the face. Treatment con tains tricyclic thymoleptics and, with less success, carbamazepine.