Sodium Valproate in Trigeminal Neuralgia

Peiris, J B; Perera, G. L. S.; Devendra, Senan; Lionel, N. D. W.

doi:10.5694/j.1326-5377.1980.tb131854.x

Cited by 79 publications

(18 citation statements)

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“…Sodium valproate has been found to provide significant pain relief in patients of post‐herpetic and diabetic peripheral neuropathy, with little incidence of adverse reactions. Sodium valproate has also been shown to be beneficial in trigeminal neuralgia . However, studies have shown that sodium valproate had no effect on pain in polyneuropathy, cancer‐related neuropathy and chronic central pain after spinal cord injury …”

Section: Discussionmentioning

confidence: 99%

The use of low‐dose sodium valproate in the management of neuropathic pain: illustrative case series

Pirapakaran

Aggarwal

2016

Internal Medicine Journal

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Anti-epileptic drugs are commonly used in the management of neuropathic pain. Sodium valproate, however, is an anti-epileptic drug that is not commonly used. We report four patients with neuropathic pain who responded very well to the initiation of low-dose oral sodium valproate. Low-dose sodium valproate may have a role in managing neuropathic pain, especially when other first-line agents are unsuccessful or relatively contraindicated.

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Section: Discussionmentioning

confidence: 99%

The use of low‐dose sodium valproate in the management of neuropathic pain: illustrative case series

Pirapakaran

Aggarwal

2016

Internal Medicine Journal

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“…Die Valproinsäure erhöht die Konzentration von GABA im ZNS und soll postsynaptische GABA-A-Rezeptoren erregen. In einer offenen Studie zur Trigeminusneuralgie konnte der Schmerz bei der Hälfte der Patienten in einer Dosis bis zu 1200 mg/Tag deutlich reduziert werden [26].…”

Section: Gaba-erge Inhibition Der Schmerzwahrnehmungunclassified

Neuropathische Schmerzen - Mechanismen und Therapie

Birklein¹

2002

Fortschr Neurol Psychiatr

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Traditionally, neuropathic pain has been classified due to aetiology of nerve damage-traumatic, inflammatory or metabolic, for instance. Based on this classification, pain therapy often is insufficient. Recent research revealed different mechanisms, which are responsible for the generation of pain after nerve lesion. These mechanisms seem to be independent of aetiology of the nerve damage. The most important mechanisms are accumulation of sodium channels on injured nerves, pathological sympatho-afferent coupling, disinhibition of nociception and central or peripheral nociceptive sensitisation. Each individual mechanism could be treated specifically by current available drugs, or by non-drug therapy. However, future research has to focus on exploring tools to recognise individual pain mechanisms in single patients. Thereby treatment will become more effective.

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“…The effectiveness of valproate for the pain of trigeminal neuralgia was evaluated in a single open‐label trial, where it demonstrated some benefit 30 . Up to 12% of patients are unable to tolerate the gastrointestinal effects associated with divalproex, although these effects can be alleviated if the drug is taken with food.…”

Section: Paroxysmal Facial Pain: Trigeminal Neuralgiamentioning

confidence: 99%

Antiepileptic Drugs in the Management of Cluster Headache and Trigeminal Neuralgia

Rozen

2001

Headache

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Cluster headache and trigeminal neuralgia are relatively rare but debilitating neurologic conditions. Although they are clinically and diagnostically distinct from migraine, many of the same pharmacologic agents are used in their management. For many patients, the attacks are so frequent and severe that abortive therapy is often ineffective; therefore, chronic preventive therapy is necessary for adequate pain control. Cluster headache and trigeminal neuralgia have several distinguishing clinical features. Cluster headache is predominantly a male disorder; trigeminal neuralgia is more prevalent in women. Individuals with cluster headaches often develop their first attack before age 25; most patients with trigeminal neuralgia are between age 50 and 70. Cluster headaches are strongly associated with tobacco smoking and triggered by alcohol consumption; trigeminal neuralgia can be triggered by such stimuli as shaving and toothbrushing. Although the pain in both disorders is excruciating, cluster headache pain is episodic and unilateral, typically surrounds the eye, and lasts 15 to 180 minutes; the pain of trigeminal neuralgia lasts just seconds and is usually limited to the tissues overlying the maxillary and mandibular divisions of the trigeminal nerve. Cluster headache is unique because of its associated autonomic symptoms. Although the pathophysiology of cluster headache and trigeminal neuralgia are not completely understood, both appear to have central primary processes, and these findings have prompted investigations of the effectiveness of the newer antiepileptic drugs for cluster headache prevention and for the treatment of trigeminal neuralgia. The traditional antiepileptic drugs phenytoin and carbamazepine have been used for the treatment of trigeminal neuralgia for a number of years, and while they are effective, they can sometimes cause central nervous system effects such as drowsiness, ataxia, somnolence, and diplopia. Reports of studies in small numbers of patients or individual case studies indicate that the newer antiepileptic drugs are effective in providing pain relief for trigeminal neuralgia and cluster headache sufferers, with fewer central nervous system side effects. Divalproex has been shown to provide effective pain control and to reduce cluster headache frequency by more than half in episodic and chronic cluster headache sufferers. Topiramate demonstrated efficacy in a study of 15 patients, with a mean time to induction of cluster headache remission of 1.4 weeks (range, 1 day to 3 weeks). In the treatment of trigeminal neuralgia, gabapentin has been shown to be effective in an open-label study. When added to an existing but ineffective regimen of carbamazepine or phenytoin, lamotrigine provided improved pain relief; it also may work as monotherapy. Topiramate provided a sustained analgesic effect when administered to patients with trigeminal neuralgia. The newer antiepileptic drugs show considerable promise in the management of cluster headache and trigeminal neuralgia.

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Sodium Valproate in Trigeminal Neuralgia

Cited by 79 publications

References 0 publications

The use of low‐dose sodium valproate in the management of neuropathic pain: illustrative case series

The use of low‐dose sodium valproate in the management of neuropathic pain: illustrative case series

Neuropathische Schmerzen - Mechanismen und Therapie

Antiepileptic Drugs in the Management of Cluster Headache and Trigeminal Neuralgia

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