Therapy
For the treatment of trigeminal neuralgia, drugs from epilepsy therapy are used, which help well with this type of pain. The first choice would be carbamazepine, which is dosed slowly and taken as a monotherapy. For acute pain, carbamazepine can be taken in its fast-acting form.
In the course of time, if the response is good, the therapy can be slowly reduced again. In trigeminal neuralgia it is important to note that normal painkillers such as ibuprofen or paracetamol have no effect. The therapy for acute cluster headaches consists of inhaling 100% oxygen and taking triptans, which can be injected under the skin or taken as a nasal spray.
Prophylaxis plays an important role in this disease, as the pain is a great pain for the patients. Cortisone is usually administered as short-term prophylaxis, but long-term prophylaxis should always be considered. Here, verapamil, a calcium antagonist, is mainly used. Normal painkillers are also ineffective here.
Duration
The duration of trigeminal attacks is limited to a few seconds, but as mentioned above, they can repeat very often one after the other. About one third of patients experience only one episode in their lives. However, this condition often worsens in the course of life.Over 50% of those affected have pain-free phases lasting more than six months.
In every fifth person, these phases last for over a year. Cluster headache is divided into episodic and chronic forms. In the episodic form, which about 75% of patients have, they are pain-free for at least one month. 25% of patients suffer from chronic pain that has no or only short phases of pain relief.
What is the prognosis?
The therapy of trigeminal neuralgia has a relatively good prognosis. About 80% of patients respond well to the medication, although higher and higher doses are required to achieve the same effect. Nevertheless, there are several drugs that can be tried out.
Under certain conditions, the compression of the nerve can be surgically removed, with quite good success rates of up to 82% pain-free patients. The prognosis for cluster headache is somewhat modest, with a spontaneous recovery of 40% in the episodic form and 17% in the chronic form. In up to 15% of cases, episodic headache develops into a chronic form. However, both oxygen and medication have very good response rates and can relieve the pain quickly.
