Fig. 3.

Evidence-based treatment algorithm for the management of acute exacerbations of trigeminal neuralgia. Management of acute exacerbations should proceed in parallel with a more definitive long-term management plan. The quality of evidence is included after each intervention. The moderate- and high-quality evidence receives a ‘should consider’ recommendation. The very low- and low-quality evidence are options that the clinician ‘may consider’ if interventions with higher quality evidence are contraindicated or not available. *Sumatriptan injection pens in the UK contain 6 mg in 1 ml, and we have recommended this for convenience as opposed to the 3 mg used by the Japanese group. ^†These concentrations may not be available in all countries (2–5% more common). TN, trigeminal neuralgia.