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Challenging Case in Clinical Practice: Multimodal Management of Concurrent Structural and Virally Exacerbated Trigeminal Neuralgia
Integrative & Complementary Therapies ; 29(2):67-71, 2023.
Article in English | CINAHL | ID: covidwho-2305643
ABSTRACT

Introduction:

Trigeminal neuralgia (TN) is among the most painful disorders of the orofacial region. Although TN has many possible etiologies, such as nerve compression, recently published evidence suggests that TN, or its exacerbations, may be the result of viral infections in the head and neck. This case presents clinical findings from a TN patient experiencing virally-induced exacerbations treated with intravenous (IV) magnesium sulfate and oral anti-inflammatories who was previously non-responsive to first-line pharmaceuticals.

Methods:

AM is a 51-year-old cis-female with a four-year history of TN caused by vascular encroachment of the trigeminal nerve and exacerbated by episodes of viral sinusitis and COVID-19. AM presented to the National University of Natural Medicine clinic in May 2019 and again in April 2022. After screening for contraindications, she was started on an IV Myer's push with an elevated dose of magnesium sulfate and oral anti-inflammatories curcumin and omega-3.

Results:

Since her second presentation to our clinic in April 2022, the patient has undergone 11 treatments and reports significant benefit in pain and quality of life. Despite the initial MRI revealing vascular encroachment on her trigeminal nerve she experienced benefit from her treatment regimen and denied a neurosurgical consultation and repeat MRI.

Conclusion:

This study contributes to a growing body of literature suggesting that cranial neuralgias may be exacerbated by orofacial or upper-respiratory viral infections and that TN specifically may be well managed with IV nutrient therapy and oral anti-inflammatories. Given the paucity of successful treatment strategies, exploring cost-effective treatments with low side effect profiles is a worthwhile approach to improving clinical outcomes in patients with TN.
Keywords

Full text: Available Collection: Databases of international organizations Database: CINAHL Type of study: Prognostic study Language: English Journal: Integrative & Complementary Therapies Year: 2023 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: CINAHL Type of study: Prognostic study Language: English Journal: Integrative & Complementary Therapies Year: 2023 Document Type: Article