Trigeminal neuralgia: successful antiepileptic drug combination therapy in three refractory cases

Figures & data

Table 1 Characteristics and treatments used in three patients with trigeminal neuralgia

	Gender	Age (years)	Trigeminal branch involved	Nonpharmacologic treatments	Single AED treatment (duration)	Non-AEDs pharmacologic treatment	VAS before CT	CT with AED (duration)	VAS after CT
A	F	70	I, II, III	Decompressive neurosurgical treatment Acupuncture (12 sessions) Trigeminal blockade with local anesthetic and cortisone	CBZ 200 5 mg/day (8 years)	Doxepine 10 mg/day Amitriptyline 4% 5 g/day	VAS 6	CBZ 100 mg + GBP 100 mg (1 month)	VAS 0
B	M	67	II	Decompressive neurosurgical treatment Dental treatment Acupuncture (20 sessions) Sphenopalatine ganglion blockade (transnasal/transoral) and infraorbital nerve blockade transoral) with local anesthetic and clonidine Trigger point injections with local anesthetic and clonidine TENS and laser sessions in trigeminal territory	PGB 75 mg + 25 mg/day (1 year)	Citalopram 10 mg/day Lormetazepam 0.25% 20 gtt/day Oxycodone 10 mg × 2/day Alphalipoic acid + vitamins 400 mg × 2/day Tramadol 150 mg/day Etoricoxib 90 mg/day	VAS 5	CBZ 100 mg + PGB 75 mg (1 month)	VAS 0
C	F	48	III		GBP 100 mg × 3/day (7 months)	Tramadol 100 mg × 3/day Indomethacin 100 mg/day Tizanidine 4 mg/day Baclofen 25 mg/day	VAS 4	CBZ 300 mg + GBP 100 mg (7 months)	VAS 1

Abbreviations: AED, antiepileptic drug; CT, combination therapy; VAS, visual analog scale (0–10); GBP, gabapentin; CBZ, carbamazepine; PGB, pregabalin; TENS, Transcutaneous Electrical Nerve Stimulation.