American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is an adjunctive therapy option for trigeminal neuralgia?

1. Pharmacotherapy only

2. Intravenous fluids

3. Baclofen

4. Dietary changes

The correct answer is: Baclofen

Baclofen is an adjunctive therapy option for trigeminal neuralgia due to its muscle relaxant properties and ability to modulate nerve transmission. It works primarily as a gamma-aminobutyric acid (GABA) receptor agonist, which helps to decrease neurotransmitter release and diminish the excitability of nerve pathways involved in pain transmission. This can be particularly beneficial in patients who experience neuropathic pain, as it can help to reduce the frequency and intensity of pain episodes. In the management of trigeminal neuralgia, baclofen is often used alongside primary pharmacotherapy options, such as carbamazepine or oxcarbazepine, to achieve better overall pain control. This combination approach targets different mechanisms of pain, leading to improved outcomes for individuals suffering from this condition. Other options mentioned do not specifically target the underlying neurophysiological mechanisms of trigeminal neuralgia. For instance, while dietary changes may help with general pain management and health, they are not considered effective for providing relief from the specific pain associated with trigeminal neuralgia. Similarly, intravenous fluids are not relevant in the context of managing trigeminal neuralgia, and pharmacotherapy alone does not encompass the full range of treatment strategies that may be beneficial