Which of the following is the least appropriate treatment for trigeminal neuralgia, characterized by sharp, painful spasms on one side of the face?

The least appropriate treatment for trigeminal neuralgia is the use of calcium channel blockers. Trigeminal neuralgia is primarily managed with medications that target nerve pain and modify neural activity. Anti-seizure drugs, like carbamazepine and oxcarbazepine, are often the first-line treatment because they stabilize the electrical activity in the nerves and help alleviate the sharp, painful spasms associated with the condition.

Tricyclic antidepressants, such as amitriptyline or nortriptyline, are also effective due to their ability to help modulate pain pathways in the brain. These medications can provide relief by enhancing neurotransmitter levels that help improve mood and decrease the perception of pain.

While muscle relaxants may have some ancillary benefits in managing muscle tension or discomfort, they do not directly target the underlying neural mechanisms that cause the acute pain experienced in trigeminal neuralgia. Calcium channel blockers, on the other hand, are primarily indicated for conditions like hypertension or certain types of angina and do not typically address the same pain pathways involved in trigeminal neuralgia. Therefore, they are not considered an appropriate treatment option for this condition.