Therapie und Prophylaxe von Gesichtsneuralgien und anderen Formen der Ge- sichtsschmerzen - Überarbeitete Empfehlungen der Deutschen Migräne- und Kopfschmerzgesellschaft -

Summary Trigeminal neuralgia and postherpetic neuralgia are the most relevant neuralgiform facial pain syndromes. Trigeminal neuralgia is characterized by lancinating intensive pain attacks of very short duration, triggered by external cues, whereas postherpetic neuralgia consists predominantly of long-lasting burning pain. Sodium channel blocking drugs are first choice in treatment of trigeminal neuralgia, operative procedures encompass microvascular decompression, thermocoagulation and percutaneous retrogasserian glycerol rhizotomy. In the acute stage postherpetic neuralgia is treated antivirally and analgetically, in the chronic stage by tricyclic antidepressive substances. Even without evidence-based studies, newer antiepileptic drugs may be applied with success, since the efficacy may be clarified within days. Other pain syndromes described encompass the TolosaHunt syndrome, cervicogenic headache, craniomandibular dysfunction syndrome, atypical facial pain and rarer syndromes. Therapeutic recommendations are based on evidence based medicine criteria (EBM). Schlusselworter: Trigeminusneuralgie, Zosterneuralgie, Tolosa-Hunt-Syndrom, Nacken-Zungensyndrom, Kraniomandibulares Dysfunktionssyndrom, cervikogener Kopfschmerz, atypischer Gesichtsschmerz