Background:
Trigeminal neuralgia (TNN) is a disabling facial pain disorder marked by sudden unilateral paroxysms, most often in the maxillary or mandibular branches. Prevalence is 4–29 cases per 100,000 persons, with female predominance. Pharmacological therapy is a first-line treatment and microvascular decompression is the surgical standard, but both are limited by resistance, intolerance, or procedural risk. Injectable therapies have recently emerged as minimally invasive alternatives. This review systematically evaluated their efficacy and safety in TNN.

Methods:
A systematic search of PubMed (MEDLINE) and the Cochrane Library was performed for studies published between 2015 and 2025 using the terms “trigeminal neuralgia AND injection.” Eligible studies were randomized trials or cohort studies including ≥20 adults with classical TNN treated by injectable therapies and reporting pain or safety outcomes. From 363 records, 13 studies met inclusion criteria.

Results:
Thirteen studies (seven randomized trials; six cohorts; ~840 patients) were analyzed. Botulinum toxin A (BTX-A) was most studied (n = 27–152), reducing pain by 40–70% and attack frequency by up to 60%, with ≥50% responders in 55–91% and relief lasting 3–6 months. A pilot trial (n = 81) found single-dose BTX-A more durable than repeated dosing. Ozone therapy (n = 103) lowered VAS from 8.1 to 2.9 at 12 months. Calcitonin-enhanced blocks (n = 30, n = 33) prolonged analgesia up to 35 weeks and reduced drug use. Corticosteroid–anesthetic blocks (n = 72), bupivacaine adjuncts (n = 73), and guanfacine–lidocaine (n = 37) also showed significant benefits. Adverse effects were mild and transient.

Conclusions:
Injectable therapies demonstrate consistent efficacy and safety in TNN. BTX-A and calcitonin have the strongest evidence, while other modalities remain promising but less studied. They may represent a minimally invasive option for refractory patients pending validation in larger multicenter trials.

Introduction: Epilepsy is one of the most prevalent chronic neurological disorders, associated with significant morbidity, higher risk of injuries, premature mortality, and socioeconomic impact. Analyzing national indicators is essential to understand regional disparities and support public policies aimed at early diagnosis, treatment, and prevention.

Methodology: This is a retrospective descriptive study based on DATASUS data (2015–2024), including records of hospital admissions, deaths, standardized rates and mortality rates due to epilepsy (ICD-10 G40). Temporal trends and regional differences were analyzed.

Results and Discussion:
The data revealed a total of 560,830 hospitalizations during the analyzed period. Among the results, the Southeast region presented the highest number of hospitalizations (231,111), while the North region registered the lowest (31,342). Regarding mortality, the Southeast also accounted for the highest number of deaths (7,253), whereas the North recorded the lowest (752) in the same period.

The annual analysis demonstrated a progressive increase in mortality rates, with the highest rate observed in 2024 (3.0%), followed by 2023 (2.89%) and 2022 (2.75%). The lowest rates were recorded between 2015 (2.23%) and 2019 (2.38%). Therefore, consistent with the findings reported by Ling-Zhi Yang et al., epilepsy remains an important cause of disability and mortality, as evidenced by the data from the analyzed period.

Conclusion: Epilepsy remains a significant burden on the Brazilian public health system, with increasing admissions, rising costs, and persistent regional disparities. Expanding access to diagnostic tools, specialized consultations, and a continuous supply of antiepileptic drugs is crucial to reduce mortality and healthcare expenditures. However, this study is limited by its reliance on secondary data from DATASUS, which may be subject to underreporting, coding inconsistencies, and a lack of clinical details, potentially underestimating the true burden of epilepsy.

_{Introduction: Intractable chronic pain affects approximately 1.5 billion people worldwide, representing a complex syndrome that transcends physical symptomatology to encompass psychological, social, and functional dimensions. This condition demonstrates significant comorbidity with depression (39.3% prevalence) and anxiety, necessitating specialized psychological interventions. The objective of this study was to systematically examine evidence-based psychological interventions for intractable chronic pain management within clinical, hospital, and health psychology frameworks.}

_{Methods: A comprehensive systematic review was conducted across major biomedical and psychological databases including PubMed, PsycINFO, and Cochrane Library. Search terms included chronic pain, psychological interventions, cognitive-behavioral therapy, acceptance and commitment therapy, mindfulness-based interventions, and positive psychology approaches. Inclusion criteria encompassed adult populations with a chronic pain duration >3 months, experimental or quasi-experimental designs, and peer-reviewed publications from the last decade. Quality assessment was performed using established methodological criteria.}

_{Results: Evidence demonstrates that multimodal psychological interventions produce significant improvements across multiple domains. Cognitive-behavioral therapy showed small to moderate effect sizes for pain intensity, physical functioning, and emotional well-being with sustained long-term benefits. Acceptance and commitment therapy effectively reduced depression symptoms, anxiety, psychological inflexibility, and pain catastrophizing while improving mindfulness and psychological flexibility. Mindfulness-based interventions (MBSR/MBCT) demonstrated significant reductions in pain intensity and psychological distress with associated neurobiological changes in pain-processing brain regions. Positive psychology interventions improved mental health outcomes, particularly well-being, life satisfaction, and psychological resilience. Multidisciplinary pain management programs integrating psychological components showed superior outcomes compared to single-modality treatments.}

_{Conclusions: Specialized psychological interventions represent essential components of comprehensive chronic pain management. The evidence supports the implementation of integrated, multidisciplinary approaches that address biological, psychological, and social dimensions of intractable chronic pain. Clinical psychologists in hospital and health settings provide crucial expertise in assessment, treatment, and interdisciplinary coordination, significantly improving patient outcomes and quality of life.}