{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T07:52:19Z","timestamp":1762069939808,"version":"build-2065373602"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the response to treatment of acute trigeminal neuralgia (TN) exacerbations in the emergency department (ED).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>TN is characterized by recurrent and intense pain paroxysms. Some patients experience severe acute exacerbations requiring ED presentation. The optimal management of these episodes is not well established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present a case series of TN exacerbations in adults who presented to the ED of a tertiary center from January 2008 to December 2020. We analyzed demographic and clinical data, including pharmacological management in the ED. The primary outcome was pain relief, classified into \u201cno relief,\u201d \u201cpartial relief,\u201d and \u201csatisfactory relief\u201d based on the qualitative description in the ED's records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ultimately 197 crisis episodes corresponding to 140 patients were included. Most were women (61%, 121\/197) with a median age of 63\u2009years (interquartile range: 52\u201373). Acute TN exacerbations were treated with opioids in 78% (108\/139) of crisis episodes, nonsteroidal anti\u2010inflammatory drugs in 42% (58\/139), corticosteroids in 21% (29\/139), intravenous phenytoin in 18% (25\/139), and intravenous lidocaine in 6% (8\/139). Of the 108 cases treated with opioids, 78 (72%) required additional drugs for pain management. Intravenous phenytoin allowed satisfactory pain relief in 64% of cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In our sample, opioids were the most used therapeutic approach in acute TN exacerbations despite their low efficacy and subsequent need for further drug treatment in most cases. Most crisis episodes managed with intravenous phenytoin reached total pain relief. Prospective studies are needed to guide the treatment of acute exacerbations of TN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14373","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T07:48:22Z","timestamp":1661413702000},"page":"1002-1006","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Treatment of acute exacerbations of trigeminal neuralgia in the emergency department: A retrospective case series"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9133-4441","authenticated-orcid":false,"given":"Maria Jo\u00e3o","family":"Pinto","sequence":"first","affiliation":[{"name":"Department of Neurology Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Department of Clinical Neurosciences and Mental Health, Faculty of Medicine University of Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Gomes","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences and Mental Health, Faculty of Medicine University of Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madalena","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Neurology Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Abreu","sequence":"additional","affiliation":[{"name":"Department of Neurology Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Department of Clinical Neurosciences and Mental Health, Faculty of Medicine University of Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5331-9934","authenticated-orcid":false,"given":"Andreia","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Neurology Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Department of Clinical Neurosciences and Mental Health, Faculty of Medicine University of Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2018.02.006"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.11.013"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000853"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","unstructured":"Headache Classification Committee of the International Headache Society (IHS).The 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