Treatment of trigeminal neuralgia with low doses of topiramate

Abstract

-Topiramate was administered to eight patients with classical trigeminal neuralgia with or without previous symptomatic therapy with other antiepileptic drugs. The topiramate doses ranged from 50 to 100 mg a day, according to the clinical response and the reported side effects. Three patients had complete symptoms remission, three reported moderate improvement, and the treatment was not effective in two. The most frequently registered side effects were dizziness, somnolence and weight loss. Topiramate can be considered an alternative treatment for patients with trigeminal neuralgia.Key WoRdS: trigeminal neuralgia, topiramate, antiepileptic drugs. Tratamento da neuralgia do trigêmeo com baixas doses de topiramatoReSumo -oito pacientes com neuralgia do trigêmeo, com ou sem tratamentos prévios com anticonvulsivantes, foram submetidos a tratamento com topiramato. As doses de topiramato variaram de 50 a 100 mg ao dia, de acordo com a resposta clínica e com os efeitos colaterais relatados. Três pacientes obtiveram remissão completa, três relataram melhora parcial e o tratamento com topiramato foi ineficaz em dois pacientes. os efeitos colaterais mais frequentemente citados foram tontura, sonolência e perda de peso. o topiramato pode ser considerado uma alternativa potencialmente eficaz para o tratamento de pacientes com neuralgia do trigêmeo.PAlAvRAS-ChAve: neuralgia do trigêmio, topiramato, drogas anti-epilépticas. [4][5][6][7] . Topiramate is a new antiepileptic drug that blocks sodium channels, enhances GABA activity by interacting with a non-benzodiazepine site on GABA A receptors, and selectively blocks AmPA/kainite glutamate receptors 8 . Some studies have demonstrated that topiramate can be considered an alternative treatment for classical and symptomatic trigeminal neuralgia 9,10 .We report our experience on the use of topiramate for trigeminal neuralgia. METHODeight patients attended in the emeSCAm headache Clinic were included in this study. All of them were diagnosed as having classical trigeminal neuralgia according to the International Classification of headache disorders 11 . Previous treatments for TN were recorded. All of them reported frequent and intense pain episodes when topiramate was started. The initial dose was 25 mg once a day.

Treatment of chronic pain in dentistry using anticonvulsants

“…It also can be considered a drug for alternative treatment of classic and symptomatic trigeminal neuralgia. The main adverse effects mentioned are dizziness, drowsiness, weight loss and nausea 9 .…”

“…In the study conducted by Domingues et al 9 , were analyzed eight patients diagnosed with classic trigeminal neuralgia. The initial administrated dose of topiramate to patients ranged from 25mg to 100mg per day.…”

“…The surgical treatment occurs through neurosurgical decompression of the trigeminal root, aiming the eliminating the distortion of the trigeminal nerve entry zone in elongated vessels, tumors, granulomas, arachnoid adhesions, among others. The improvement of symptoms is immediate in most cases [4][5]9 .…”

Классическая Невралгия Тройничного Нерва

“…В мире проводятся масштабные исследования по эффектив-ности других противосудорожных препаратов: окскарбазепин, клоназепам, ламотриджин, вальпроаты, габапентин [197,255,295,304,344,379,384,421].…”

Safety of topiramate for treating migraines

“…Recently the FDA approved a combination of phentermine and topiramate for the treatment of obesity in association with hypertension, type 2 diabetes, or dyslipidemia [10]. Off-label uses of topiramate in headache disorders include chronic migraine [11], trigeminal neuralgia [12], cluster headache [13], and idiopathic intracranial hypertension [14].…”