Efficacy Of Gabapentin In Trigeminal Neuralgia: A Non-randomized Trial
DOI:
https://doi.org/10.51985/JBUMDC2018045Keywords:
Trigeminal Neuralgia, carbamazepine, GabapentinAbstract
Objective: To compare the efficacy of Gabapentin with carbamazepine in Trigeminal Neuralgia.
Material/Method: The study was conducted in Agha Khan University Hospital and Abbasi Shaheed Hospital for four
months. 19 patients of TN were collected through purposive convenience sampling. DN4 questionnaire was used to
differentiate between Somatic and Neuropathic pain. Numeric Pain Rating Scale was used to assess the severity of pain.
Results: Nine patients of Trigeminal Neuralgia refractory to carbamazepine were put on Gabapentin with male to female
ratio of 4:5. All showed favorable response on 800-1600 mg Gabapentin on Numeric Pain Rating Scale. All patients were
pain free in three weeks with no side effects. There was significant difference between pain response to carbamazepine
and Gabapentin at P< .05. Four patients (44%) had pain relief on 900 mg Gabapentin, three (33%) on 1200 mg, one
responded on 800 mg and one on 1600 mg.
Conclusion: Gabapentin is effective as first line treatment in Trigeminal Neuralgia
References
Katsuhiro Toda, Trigeminal Neuralgia —Symptoms, Diagnosis,
Classification, and Related Disorder, Oral Science International,
vol. 4, no. 1, pp. 1–9, 2007.
Zvartau-Hind M, Din MU, Gilani A, Lisak RP, Khan OA.
Topiramate relieves refractory trigeminal neuralgia in MS
patients. Neurology. 2000;55(10):1587-8.
Bennetto L, Patel NK, Fuller G. Trigeminal neuralgia and its
management. BMJ. 2007;334(7586):201-5.
Mackey S, Feinberg S. Pharmacologic therapies for complex
regional pain syndrome. Curr Pain Headache Rep.
;11(1):38-43.
Campbell JK. Trigeminal neuralgia: are all of the treatment
options being considered?. Headache. 1997; 37(1):H3.
Love S, Coakham HB. Trigeminal neuralgia: pathology and
pathogenesis. Brain. 2001;124:2347–60.
Cheshire WP Jr. The shocking tooth about trigeminal neuralgia.
N Engl J Med. 2000;342(26):2003.
Chole R, Patil R, Degwekar SS, Bhowate RR. Drug treatment
of trigeminal neuralgia: a systematic review of the literature.
J Oral Maxillofac Surg. 2007;65(1):40-5.
Devor M, Amir R, Rappaport ZH. Pathophysiology of
trigeminal neuralgia: the ignition hypothesis. Clin J Pain.
;18:4–13.
Jackson EM, Bussard GM, Hoard MA, Edlich RF. Trigeminal
neuralgia: a diagnostic challenge. Am J Emerg Med.
;17(6):597-600.
Hassan S, Khan NI, Sherwani OA, Bhatt W, Asif S. Trigeminal
neuralgia: an overview of literature with emphasis on medical
management. Int Research J Pharmcol. 2013;3:235–238.
Reddy GD, Viswanathan A. Trigeminal and glossopharyngeal
neuralgia. Neurol Clin. 2014;32(2):539–552.
Zakrzewska JM, Linskey ME. Trigeminal neuralgia. BMJ.
;348:g474.
Cruccu G. Trigeminal neuralgia. Continuum (Minneap Minn)
;23:396–420. 2, Selected Topics in Outpatient Neurology
Kubitz PK, Wijdicks EF, Bolton CF. Tic douloureux or "tic
dentaire". Neurology. 2004;62(2):333.
Liu JK, Apfelbaum RI. Treatment of trigeminal neuralgia.
Neurosurg Clin N Am. 2004;15(3):319-34.
Obermann M, Yoon MS, Sensen K, et al. Efficacy of pregabalin
in the treatment of trigeminal neuralgia. Cephalalgia.
;28:174–181.
Rozen TD. Antiepileptic drugs in the management of cluster
headache and trigeminal neuralgia. Headache. 2001;41:
S25–S32.
Rasche D, Kress B, Schwark C, Wirtz CR, Unterberg A,
Tronnier VM. Treatment of trigeminal neuralgia associated
with multiple sclerosis: case report. Neurology. Nov 9
;63(9):1714-5.
Joffroy A, Levivier M, Massager N. Trigeminal neuralgia.
Pathophysiology and treatment. Acta Neurol Belg.
;101:20–25.
Keppel Hesselink JM, Schatman ME. Phenytoin and
carbamazepine in trigeminal neuralgia: marketing-based versus
evidence-based treatment. Journal of Pain Research.
;10:1663-1666.
Ghita Harifi, Imane Ouilki. Validity and Reliability of the
Arabic Adapted Version of the DN4 Questionnaire (Douleur
Neuropathique 4 Questions) for Differential Diagnosis of
Pain Syndromes with a Neuropathic or Somatic Component.
Pain Pract. 2011;11(2):139-47.
Cleland JA, Childs JD and Whitman JM, Psychometric
properties of the Neck Disability Index and Numeric Pain
Rating Scale in patients with mechanical neck pain. Arch
Phys Med Rehabil. 2008;89(1):69-74.
Cheshire WP., Jr Defining the role for gabapentin in the
treatment of trigeminal neuralgia: a retrospective study. J
Pain. 2002;3:137–142
Serpell MG Neuropathic pain study group. Gabapentin in
neuropathic pain syndromes: a randomised, double-blind,
placebo-controlled trial. Pain. 2002;99:557–566.
George M, Selvarajan S, Indumathi C. Drug therapy for
trigeminal neuralgia. e-Journal of Dentistry. 2011;1:28–31.
Anand KS, Dhikav V, Prasad A, Shewtengna. Efficacy, safety
and tolerability of duloxetine in idiopathic trigeminal neuralgia.
J Indian Med Assoc. 2011;109(4):264-6
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2018 Nasir Ali Khan; Samia Siraj, Usman Mahmood, Fauzia Sidiqui, Daud Mirza, Muhammad Shahrukh Khan Sadiq, Beenish Fatima Alam
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0