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09:35
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
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In-Hospital Management of Acute Trigeminal Neuralgia Pain Crises
Alyssa Chow1, Imran Haider2, Alexandra Athanaselos3
1Department of Medicine, Queen's University, Kingston, Ontario, Canada.
Clinical Medicine & Research
|February 24, 2025
Summary
Acute trigeminal neuralgia (TN) pain crises require specific management. Phenytoin effectively resolved severe TN pain in a patient, highlighting its potential as a rescue medication.
Area of Science:
- Neurology
- Pain Management
- Pharmacology
Background:
- Trigeminal neuralgia (TN) is a common craniofacial neuropathic pain condition.
- Acute TN exacerbations significantly impact quality of life, necessitating effective emergency management.
- Current treatments often involve ineffective analgesics like opioids, indicating a need for better acute care strategies.
Purpose of the Study:
- To review evidence for pharmacological management of acute trigeminal neuralgia (TN).
- To highlight the role of specific medications as rescue therapy during TN pain crises.
- To present a case study illustrating successful treatment of acute TN.
Main Methods:
- Literature review of pharmacological therapies for acute TN.
- Case report of a 58-year-old male patient with acute TN.
- Analysis of treatment outcomes focusing on phenytoin, fosphenytoin, and lidocaine.
Main Results:
- Phenytoin demonstrated complete pain resolution in the presented case.
- Evidence supports fosphenytoin, phenytoin, and lidocaine as potential rescue medications for acute TN.
- Opioid use in acute TN is discouraged due to lack of efficacy and adverse effects.
Conclusions:
- Phenytoin can be an effective rescue medication for acute trigeminal neuralgia pain crises.
- Improved physician knowledge of acute TN management is crucial, especially for non-specialist care.
- Evidence-based pharmacological interventions are needed to replace ineffective treatments like opioids.
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