Investigation and medical management of trigeminal neuralgia by consultantoral and maxillofacial surgeons in the British Isles

Trigeminal neuralgia is an extremely painful affliction of the face that is treated by various specialists including oral and maxillofacial surgeons. Some aspects of its management remain controversial, including screening fo r secondary trigeminal neuralgia, and the monitoring of treatment with carb amazepine. There is, however, little information available about current pr actice. A postal questionnaire was sent to 254 fellows of the British Assoc iation of Oral and Maxillofacial Surgeons (BAOMS) about various aspects of the management of trigeminal neuralgia. One hundred and seventy nine replie s (70%) were received. Orofacial and cranial nerve examinations were undert aken by the majority of surgeons, but most did not routinely arrange comput ed tomography or magnetic resonance imaging for all patients, nor did they refer the patient to a neurologist. In contrast with current recommendation s, warnings about the adverse effects of carbamazepine were given by only a few surgeons, while most routinely monitored full blood counts. (C) 2001 T he British Association of Oral and Maxillofacial Surgeons.