Conclusions on Treatment of Facial Pain and Neuralgias

• Each of the facial pains and neuralgias has slightly different therapeutic approaches.

• Generally, medications are tried first, and usually anti-epilepsy drugs.

• The exception to this is occipital neuralgia where a block is first-line therapy. Nummular headache may also respond to local infiltration of anesthetic.

• In trigeminal neuralgia, time is of the essence due to the level of suffering. Refer to a neurosurgeon or pain anesthesiologist quickly if medications are not adequate at reasonable dose.

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