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Updated: Dec 12, 2025

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
Lacosamide in trigeminal neuralgia: report of a case refractory to first- and second-generation anticonvulsants
Daniela Adamo1, Noemi Coppola1, Giuseppe Pecoraro1
1Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy.
Background:
The treatment of trigeminal neuralgia (TN) involves first- and second-generation anticonvulsants. However, side effects (SEs) impair compliance with treatment, especially in elderly patients. Lacosamide (LCM) is a third-generation anticonvulsant with a mechanism of action that is not completely clear. It has few SEs and has been considered in the treatment of neuropathic pain.
Clinical Presentation:
LCM was prescribed as a monotherapy for a 60-year-old female with TN who had proven refractory to previous treatments in terms of both the absence of any pain relief and the appearance of severe leukopenia. The treatment dosage was 100 mg twice daily. Pain relief was obtained after three weeks of treatment without any SEs. Currently, the patient takes a maintenance dosage of 100 mg/daily, remaining in a state of complete well-being.
Conclusion:
LCM has shown evidence of a potential efficacy and a good safety profile in the treatment of this patient with TN.
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