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Trigeminal Neuralgia: Channels, Pathophysiology, and Therapeutic Challenges

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Cluster Headache and other Trigeminal Autonomic Cephalgias

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Abstract

Trigeminal neuralgia (TN) is a condition characterized by paroxysmal excruciating and usually unilateral pain attacks within the territory of one or more divisions of the trigeminal nerve. The underlying pathophysiological mechanisms remain poorly understood. The abrupt onset and termination of electric shock-like severe pain, the triggering role of non-noxious light sensory stimuli, the spreading of pain beyond the stimulated area, and the post-attack refractoriness represent some of the intriguing and challenging aspects of TN pathophysiology. This chapter reviews the updated pathophysiological hypotheses for TN, the emerging role of ion channels potentially representing novel therapeutic targets for the treatment of the disorder, and the current therapeutic approach based on a diagnostic work-up and treatment algorithm.

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Author information

Authors and Affiliations

  1. Neurophysiology and Neuroalgology Units, Department of Clinical Neuroscience, IRCCS Foundation “Carlo Besta” Neurological Institute, Milan, Italy

    Daniele Cazzato

  2. Department of Neurology, Danish Headache Center, Rigshospitalet—Glostrup, University of Copenhagen, Copenhagen, Denmark

    Stine Maarbjerg & Lars Bendtsen

  3. Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, Milan, Italy

    Giuseppe Lauria

  4. Neuroalgology Unit, Department of Clinical Neuroscience, IRCCS Foundation “Carlo Besta” Neurological Institute, Milan, Italy

    Giuseppe Lauria

Authors
  1. Daniele Cazzato
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  2. Stine Maarbjerg
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  3. Lars Bendtsen
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  4. Giuseppe Lauria
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Corresponding author

Correspondence to Giuseppe Lauria .

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Editors and Affiliations

  1. Department of Neurology, Neuroalgology Unit, The Foundation of the Carlo Besta Neurological Institute, IRCCS, Milano, Italy

    Massimo Leone

  2. Department of Systems Neuroscience, University of Hamburg, Hamburg, Germany

    Arne May

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Cazzato, D., Maarbjerg, S., Bendtsen, L., Lauria, G. (2020). Trigeminal Neuralgia: Channels, Pathophysiology, and Therapeutic Challenges. In: Leone, M., May, A. (eds) Cluster Headache and other Trigeminal Autonomic Cephalgias. Headache. Springer, Cham. https://doi.org/10.1007/978-3-030-12438-0_16

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  • DOI: https://doi.org/10.1007/978-3-030-12438-0_16

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