Therapy
Therapy treatment depends crucially on the type of inflammation. In the case of symptomatic trigeminal neuralgia, it is always advisable to treat the disease which can be primarily responsible for the occurrence of the inflammation. In addition, a suitable pain therapy is also useful to improve these symptoms.
In general, trigeminal neuralgia can be treated with medication, surgery or, more recently, radiotherapy. Carbamazepine has long been the drug of choice.The drug, which is actually used as an anti-epileptic drug (i.e. for epilepsy), is very well suited for controlling the symptoms of trigeminal neuralgia in many patients. Other drugs in this substance class, such as phenytoin, also an anti-epileptic, are also frequently used.
In some cases, a local anesthetic is injected into the affected, painful nerve to at least temporarily prevent the perception of pain. Depending on the symptoms and individual course of the disease, surgical therapy may also be considered. There are several different procedures to choose from.
In principle, a distinction must be made between two different procedures. On the one hand, there are surgical procedures in which the skull bone must be opened. Once the cranial bone is opened, parts of the trigeminal nerve can be sclerosed with different methods.
This surgical method is very successful, but can lead to complications, especially sensory disturbances in the face. On the other hand, there are surgical procedures that do not require the skullcap to be opened. There the nerve above the skull is treated.
The success rate is good, although in some patients many symptoms reappear after some time. This type of surgery is also not without complications and can also cause sensory disturbances in the face and in some cases lead to unilateral numbness. Recently, there is also the possibility to treat trigeminal neuralgia with radiotherapy.
In this method a part of the nerve is irradiated. The overall success rate is very good, with about 85% of patients treated painlessly. In some patients, symptoms recede, but about 75% of the irradiated patients are still pain-free after 3 years.
One problem in the treatment of nerve pain is that “normal” painkillers, so-called NSAIDs such as Aspirin® or Ibuprofen, have no effect on it. Therefore one has to resort to other active substances. Anticonvulsants, i.e. drugs from the therapy of epilepsy, are often used, as well as antidepressants, which are also effective for neuropathic pain.
However, they are usually given in lower doses than their original purpose. Their effect is believed to be based on the inhibition of excessive nerve activity. In this way they prevent the pain stimulus from being passed on to the brain.
If the nerve pain cannot be adequately treated with these groups of drugs, it is possible to resort to the highly effective opioids, which act centrally in the brain and prevent the transmission of pain stimuli. A very popular home remedy for trigeminal neuralgia is the application of a cold compress with lavender. To do this, lavender flowers are doused with a little boiling water.
Leave to infuse for about 15 minutes, then remove the flowers and cool the water down to about 40 degrees. Now you can dip a linen cloth into this infusion and hold it on the affected side of your face. Furthermore, cabbage leaves have proven to be effective in the treatment of neuralgia.
For this purpose, fresh cabbage leaves are used, which are then rolled out with a rolling pin so that the liquid they contain and thus the active ingredients can escape. The cabbage leaves can now simply be placed on the half of the face with a surrounding compress. They have a calming and cooling effect.
Various oils can also be used as household remedies. For example, some swear by the camphor oil soaked in crushed garlic for about a week. This can be rubbed into the area where the pain occurs.
Other oils that can help against the pain are clove oil, eucalyptus oil and basil oil. Heated linen bags filled with hay flowers can also have a pain-relieving effect. Probably the best known herbal remedy for trigeminal neuralgia is the so-called St. John’s wort (Hypericum perforatum).
This herb is used to treat nerve inflammation as well as depression. However, St. John’s wort should only be taken after consultation with a physician, as St. John’s wort influences various enzymes in the body and can thus alter the effect of other drugs. The phenomenon that antidepressants have the best effectiveness against nerve pain can also be observed in therapy with conventional drugs.
Another homeopathic remedy is the Aranea diadema. This active ingredient, which is obtained from cross spiders, actually has a toxic effect on nerves, but if the dose is well adjusted, it can also be used to treat nerve inflammation.However, the application should only take place within the framework of a professional homeopathic therapy and should not be used by laypersons themselves. In general, Arsenicum album (D6, D12, D30), Aconitum (C3, D4, D6) and Spigelia (D6, D12) are also considered by homeopaths to be well suited to combat nerve pain.
