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Treatment of neuralgia is aimed at reversing or controlling the cause of the nerve problem (if identified) as well as providing pain relief. Therefore, the treatment varies depending on the cause, location, and severity of the pain and other factors. Even if the cause of the neuralgia is never identified, the condition may improve spontaneously or disappear with time.
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The cause (if known) should be treated. This may include surgical removal of tumors, or surgical separation of the nerve from blood vessels or other structures that compress it.
Mild over-the-counter analgesics such as aspirin, acetaminophen, or ibuprofen may be helpful for mild pain. Narcotic analgesics such as codeine may be needed for a short time to control severe pain. These traditional pain-killers, however, often have disappointing results.
Other types of medications work in different parts of the nervous system and often provide better symptom control. For instance, antiseizure medications such as carbamazepine, gabapentin, lamotrigine or phenytoin may be helpful for pain associated with trigeminal neuralgia. The most common adverse effects of antiseizure drugs are drowsiness, tremor, and incoordination.
Antidepressant medications, such as amitryptiline, may be helpful to control pain in some cases. The topical (local) application of creams containing capsaicin also may help to control pain.
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