Refractory Trigeminal Neuralgia Successfully Treated with Gabapentin-A Case Report

郭 子恒(Chi-Hang Kuok), 鄭 仁坤(Jen-Kun Cheng), 吳 國驊(Kuo-Hwa Wu), 鄭 碩仁(Sho-Jen Cheng), 林 嘉祥(Chia-Shiang Lin), 黃 俊仁(Chun-Jen Kuang), 陳 建全(Chien-Chuan Chen)

Research output: Contribution to journalArticle

Abstract

Carbamazepine and its related anticonvulsants are the treatment of choice for trigeminal neuralgia for many years. But trigeminal neuralgia refractory to conventional anticonvulsant agents is still the main challenge to clinicians. We report a 42-year-old male who was a victim of trigeminal neuralgia for four years. Beside, he had undergone craniotomy and radiotherapy for right middle fossa meningioma five years ago. In general, his pain could be controlled by carbamazepine and baclofen. But the frequency and duration of the attack became severe despite the medical treatment. He described the pain sensation as sharp, stabbing and burning and it could be triggered by touch, shaving or chewing. Secondary trigeminal neuralgia was diagnosed because brain MRI examination revealed right trigeminal nerve root compression by a right parasellar area recurrent tumor. The neurologist had adjusted the medications to other traditional anticonvulsants but the pain was not resolved. The patient even tried not to eat or drink to avoid triggering the attack. Since the right internal carotid artery was involved and the risk of surgical treatment was high, radiotherapy was arranged. At the same time, we were consulted for neurolytic block. Considering the risk of the procedure, we suggested the use of gabapentin, a novel anticonvulsant and analgesic. Fortunately, the pain was relieved after one-week treatment of gabapentin and did not attack again during the 3 months follow-up. We present this case to offer another therapeutic option for trigeminal neuralgia that is refractory to traditional anticonvulsant drugs.
Translated title of the contribution以Gabapentin成功治療傳統抗癲癇藥物療效不佳的三叉神經痛-病例報告
Original languageEnglish
Pages (from-to)67-73
Number of pages7
Journal疼痛醫學雜誌
Volume14
Issue number2
DOIs
Publication statusPublished - 2004

Keywords

  • Gabapentin
  • 三叉神經痛
  • 腦膜瘤
  • gabapentin
  • trigeminal neuralgia
  • meningioma

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    郭子恒(Chi-Hang K, 鄭仁坤(Jen-Kun C, 吳國驊(Kuo-Hwa W, 鄭碩仁(Sho-Jen C, 林嘉祥(Chia-Shiang L, 黃俊仁(Chun-Jen K, & 陳建全(Chien-Chuan C (2004). Refractory Trigeminal Neuralgia Successfully Treated with Gabapentin-A Case Report. 疼痛醫學雜誌, 14(2), 67-73. https://doi.org/10.29792/TTJP.200409.0005