[Pharmacological treatment of trigeminal neuralgia: systematic review and metanalysis.].
نویسندگان
چکیده
BACKGROUND AND OBJECTIVES Trigeminal neuralgia is a syndrome of chronic pain, characterized by paroxysms of excruciating pain which dramatically affect patients' quality of life. Systemic drug therapy is the first line treatment for this disease. This study aimed at evaluating efficacy, safety and tolerability of several pharmacologic treatments offered to trigeminal neuralgia patients, trying to supply evidences for clinical practice recommendations and to identify the needs for further research. METHODS Randomized controlled clinical trials on the analgesic effects of drugs prescribed for trigeminal neuralgia were evaluated. All of them were published until July 2003. Statistical analysis was accomplished with the support of Review Manager 4.2.2 software (Cochrane Collaboration, 2003). RESULTS Metanalisys results suggest that carbamazepine is more efficient than placebo. In three controlled studies comparing lamotrigine, topiramate and 0.5% proparacaine hydrochloride, only lamotrigine was superior to placebo. Dextromethorphan was compared to low-dose lorazepam, with increased pain with dextromethorphan. Three studies have compared carbamazepine to tizanidine, tocainide and pimozide, and only pimozide was superior to carbamazepine. CONCLUSIONS Carbamazepine is still the drug of choice for treating trigeminal neuralgia, being lamotrigine and pimozide indicated for cases refractory to conventional therapy. In addition, further studies are needed to determine future therapeutic options.
منابع مشابه
Clinical aspects and pharmacological treatment of trigeminal neuralgia
Introduction: Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe and brief pain episodes within the distribution of one or more branches of the trigeminal nerve. In some patients a constant background pain may persist, additionally to pain attacks, which can make difficult to differentiate the trigeminal neuralgia from other orofacial pain types. Objective: To review the...
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Background and purpose: Trigeminal neuralgia is the most common type of facial neuralgia. The pain would easily affect the quality of life according to its acute and severe nature. Treatment modalities include pharmacotherapy, microvascular decompression, and lesioning peripheral procedures targeting the trigeminal ganglion. These methods either have side effects or are partially invasive; t...
متن کاملDrug treatment of trigeminal neuralgia: a systematic review of the literature.
PURPOSE This study undertook a systematic review of the literature on drug treatment of trigeminal neuralgia. METHODS An electronic search was carried out for articles published between January 1960 to February 2005. Studies with high level of evidence were included. The levels of evidence of the articles were classified after the guidelines of the Oxford Centre for Evidence-Based Medicine. ...
متن کاملAAN-EFNS guidelines on trigeminal neuralgia management.
Several issues regarding diagnosis, pharmacological treatment, and surgical treatment of trigeminal neuralgia (TN) are still unsettled. The American Academy of Neurology and the European Federation of Neurological Societies launched a joint Task Force to prepare general guidelines for the management of this condition. After systematic review of the literature the Task Force came to a series of ...
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عنوان ژورنال:
- Revista brasileira de anestesiologia
دوره 54 6 شماره
صفحات -
تاریخ انتشار 2004