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Around 23% of patients with TN do not respond to pharmacological treatment, and are considered eligible for surgery.68 In specialised units, up to 35% of patients are non-responders.69 The best time for surgical intervention is not well established, although it is reasonable to avoid excessive delay: surgery should ideally be considered after the first year of lack of response or intolerance to pharmacological treatment
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Organic Acid Test I also recommend a Comprehensive Organic Acid Test to look at vitamin B6 and other markers
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