Trigeminal Neuralgia Related to Inferior Alveolar Nerve Block (IANB) and Its Management with Carbamazepine Understanding Trigeminal Neuralgia and IANB Trigeminal neuralgia (TN) is a chronic pain condition affecting the trigeminal nerve, causing severe, episodic, electric shock-like pain, often triggered by mild stimulation such as talking, chewing, or touch. Though rare, dental procedures like an inferior alveolar nerve block (IANB) for local anesthesia can sometimes precipitate TN, either due to nerve trauma, chemical irritation, or anatomical predisposition. Causes of TN Post-IANB Direct Nerve Injury: Needle trauma to the nerve during injection. Chemical Irritation: Reaction to anesthetic agents leading to neurotoxicity. Pressure Injury: Hematoma formation compressing the nerve. Predisposed Neuralgia: Latent TN that becomes symptomatic post-procedure. Clinical Features Sudden, sharp, and excruciating pain along the mandibular nerve distribution. Pain episodes lasting seconds to minutes. Triggers: Chewing, speaking, or touch. No obvious dental pathology upon examination. Diagnosis Detailed History: Onset following IANB, nature, and triggers of pain. Exclusion of Dental Pathologies: Radiographic and clinical assessment to rule out infection or fracture. Neuroimaging: MRI to assess nerve compression or other underlying causes. Management with Carbamazepine Carbamazepine is the first-line pharmacological treatment for TN. It stabilizes hyperactive nerve membranes by inhibiting voltage-gated sodium channels, reducing pain frequency and intensity. Dosage and Administration: Initial dose: 100-200 mg once or twice daily. Titration: Gradually increased to a maintenance dose of 600-1200 mg/day, depending on patient response and tolerance. Regular monitoring for therapeutic levels and side effects. Side Effects: Common: Drowsiness, dizziness, nausea. Rare but serious: Bone marrow suppression, hepatotoxicity, or Stevens-Johnson syndrome (particularly in individuals with certain genetic predispositions like HLA-B*1502 in Asian populations). Adjunctive Measures Pain Modulation: Adjunct medications like gabapentin or baclofen if carbamazepine alone is insufficient. Physical Therapy: Desensitization exercises for trigger zones. Psychological Support: Addressing the psychological impact of chronic pain. Prognosis With appropriate pharmacological intervention, most cases show significant relief. However, persistent symptoms or resistance to medication may necessitate further interventions, such as: Microvascular decompression. Radiofrequency rhizotomy. Neuromodulation techniques. Preventive Considerations for Dental Practitioners Careful technique during IANB to avoid nerve injury. Patient counseling about potential risks, especially in those with a history of neuralgia. Using minimal effective anesthetic volumes. Early recognition and appropriate management of TN related to IANB can significantly improve patient outcomes, reducing the burden of this debilitating condition. Dental Clinics in West Mambalam Dentists in West Mambalam Dentists in Ashok Nagar Best dentist near me Best Dental Clinics in West Mambalam Oral surgeon in West Mambalam Dental Implants in West Mambalam