TABLE 4

Treatments for acute episodes of trigeminal neuralgia based on a systematic review

ProviderTreatment
All clinicians (dentist, general practitioner, specialist)Lidocaine

  • 10-mg nasal spray, 2 sprays into nostril on affected side; can be used intraorally, but spit out after 1 minute

  • 5% ointment to trigger area

  • 2% 1:80,000 adrenaline local infiltration to nerve block trigger area

General practitioner, specialistSumatriptan 6 mg subcutaneous injection, followed by oral sumatriptan 50 mg twice daily for 1 week
Specialist onlyBotulinum toxin type A injection, 3 mg in 1 mL
Specialist, inpatient basisIntravenous Infusions

  • Lidocaine 1.5 mg/kg over 1 hour, up to 5 mg/kg in a randomized clinical trial

  • Phenytoin 10 mg/kg

  • Fosphenytoin 15 mg/kg

  • Based on data from references 9 and 11.