ABSTRACT
@#In this study we aimed to determine the adverse effects and pain outcome following carbamazepine pharmacotherapy to manage patients with classical trigeminal neuralgia. The study was carried out on patients diagnosed with classical trigeminal neuralgia at the Faculty of Dentistry, University of Malaya. Medical records of patients diagnosed with trigeminal neuralgia over a period of 11 years from April, 2003 to April, 2014 were reviewed. A total of 49 patients who fulfilled the inclusion criteria were included in the study. Demographic details, clinical features and blood test reports of the patients were recorded from the patient’s clinical files. Subjects included in the study were administered the Faces Pain Rating Scale (FPS) and Numeric Pain Rating scale (NRS) to measure the pain outcome retrospectively. Analysis and interpretation of results was carried out using SPSS. Hepatic adverse effects were more commonly seen in our patients (n=39) followed by haematological (n=27), renal (n=23) and non-specific adverse effects (n=22). However, there was no significant association between the observed side effects and carbamazepine pharmacotherapy. Analysis of our data using Pearson Chi Square test, showed no significant correlation between gender, ethnicity and age of the patients with adverse effects. 9 out of the 49 subjects included in the study were administered the FOS and the NRS. Pain perception after treatment was significantly decreased (p-0.007) in comparison to pain perception before commencement of therapy with carbamazepine in the selected group of patients. Even though pain perception decreased in the selected patients, the data is insufficient to state the efficacy of the treatment as none of the patients reported a complete relief from their pain. The results of our study showed that there were no significant haematological, hepatic, renal, and non-specific adverse effects associated with the use of carbamazepine. The efficacy of this drug in the treatment of trigeminal neuralgia was proven to be satisfactory. It may be concluded that carbamazepine could be considered as the drug of choice in the treatment of trigeminal neuralgia.
ABSTRACT
Classical trigeminal neuralgia (CTN) is treated predominantly by pharmacotherapy but side effects and unsuccessful occurs. The current study was carried out to evaluate the therapeutic effect of combination of pharmacotherapy and lidocaine block. Thirteen patients with CTN managed with pharmacotherapy were recruited and assigned either to no additional treatment (Group I) or to additional analgesic block (Group II). The primary endpoint was the reduction in the frequency of pain episodes in a month assessed at 30 and 90 days. Comparisons of measurements of pain, general health and depression scales were secondary endpoints. The results from the follow-up visits at 30 and 90 days showed the Group II to have larger reduction in the frequency of pain and exhibited a bigger improvement in the scores of the pain, general health and depression scales. The results from this preliminary study suggest a clinical benefit of the combination of pharmacotherapy and lidocaine block.
A neuralgia clássica do trigêmio (NTC) é tratada predominantemente por drogas, porém efeitos colaterais e falhas terapêuticas ocorrem. Avaliamos o efeito terapêutico da combinação entre farmacoterapia e bloqueio analgésico utilizando a lidocaína. Treze pacientes portadores de NTC tratados com farmacoterapia foram divididos em dois grupos: Grupo I pacientes que mantiveram somente tratamento medicamentos e Grupo II pacientes que associaram bloqueio anestésico. O objetivo primário do estudo foi à redução da freqüência da dor 30 e 90 dias após o bloqueio. Secundariamente avaliamos o impacto sobre as escalas de depressão, dor e qualidade de vida. O grupo II teve uma redução significativa na freqüência da dor e uma melhora nos escores de qualidade de vida, dor e escala de depressão. Os resultados sugerem um benefício clinico da combinação de farmacoterapia e bloqueio anestésico no tratamento da NTC.