pregabalin and Trigeminal-Neuralgia

Avellis syndrome is a rare bulbar syndrome. The main lesions may involve nucleus ambiguus and the lateral spinothalamic tract. The typical reported clinical manifestations are hoarseness, dysphagia, pain, and temperature disturbance of contralateral body. The manifestations, however, may vary. We aim to report new manifestations of Avellis syndrome in this report.. A 47-year-old Chinese peasant woman who felt sudden dizziness, nausea when she was doing the laundry was referred to our department from other hospital. She vomited the stomach contents once and complained numbness of the left trunk and limbs as well as coughing while drinking. The patient presented with palatopharyngeal paralysis, Horner syndrome, and diminished pain as well as temperature sensation in the contralateral face, trunk, and limbs. She also presented with ipsilateral prosopalgia, glossopharyngeal neuralgia, and central poststroke pain.. T2-weighted MRI images demonstrated a high-signal intensity lesion in the right medulla oblongata which indicated a banded infarction site. The patient was diagnosed with medulla oblongata infarction, Avellis syndrome, Horner syndrome, dysphagia, hemiparesthesia, ipsilateral prosopalgia, glossopharyngeal neuralgia, and central poststroke pain.. The patient was administrated aspirin to prevent the aggregation of platelet and rosuvastatin tablets to regulate lipids as well as to stabilize vascular plaque. She was injected with butylphthalide sodium chloride to improve nerve nutritional status and carbamazepine was prescribed to deal with prosopalgia and glossopharyngeal neuralgia. Gabapentin and pregabalin were administrated to deal with the central poststroke pain.. The symptoms of prosopalgia as well as glossopharyngeal neuralgia were gone, and dizziness, dysphagia, and Horner syndrome were significantly alleviated when she was discharged from the hospital while the interventions showed little effect on central poststroke pain.. We reported a case of Avellis syndrome who manifested as the typical reported manifestations. The patient, what's more, presented with ipsilateral trigeminal, glossopharyngeal neuralgia, and central poststroke pain which were described for the first time. It is of great significance for clinicians to recognize the typical as well as other manifestations which helps to make a clear diagnosis.

Topics: Aspirin; Carbamazepine; Deglutition Disorders; Dizziness; Female; Gabapentin; Glossopharyngeal Nerve Diseases; Horner Syndrome; Humans; Infarction; Lipids; Middle Aged; Neuralgia; Pregabalin; Rosuvastatin Calcium; Sodium Chloride; Tablets; Trigeminal Neuralgia

Trigeminal postherpetic neuralgia (PHN) is often refractory to treatment. Pulsed radiofrequency (PRF) neuromodulation can help in preventing PHN after herpes zoster. This study aimed to compare the efficacy and safety of two different PRF modes on gasserian ganglion neuromodulation in elderly patients with acute/subacute trigeminal herpes zoster.. A total of 120 elderly patients with acute or subacute (within past three months) trigeminal herpes zoster were randomized to receive either a single cycle of high-voltage, long-duration PRF (HL-PRF group; N = 60) or three cycles of standard PRF (S-PRF group; N = 60). Patients were followed up for six months after treatment. Visual analog scale (VAS) pain score, 36-Item Short Form Health Survey (SF-36) score, and pregabalin at baseline and at different time points during follow-up were recorded.. VAS and SF-36 scores declined significantly from baseline levels in both groups (p < 0.001). The scores were significantly lower in the HL-PRF group than in the S-PRF group at some time points (p < 0.05). The mean dose of pregabalin was significantly lower in the HL-PRF group than in the S-PRF group on days 3, 14, and 28 after treatment (p < 0.05). No serious adverse events occurred in either group.. HL-PRF neuromodulation of the gasserian ganglion appears to be more effective than S-PRF for preventing PHN in the elderly.. ChiCTR2000038775.

Topics: Aged; Herpes Zoster; Humans; Neuralgia, Postherpetic; Pregabalin; Pulsed Radiofrequency Treatment; Treatment Outcome; Trigeminal Neuralgia

Effects of pregabalin (PGB) on patient-reported health outcomes were assessed in 65 PGB-naive subjects with trigeminal neuralgia refractory to previous analgesic therapy in a prospective, multicentre observational study carried out in primary care. Twelve weeks' monotherapy with PGB (n = 36) or add-on (n = 29), reduced baseline intensity of pain by a mean +/- S.D. of -40.0 +/- 22.1 mm [-55.4%, effect size (ES) 2.32; P < 0.0001] with 59.4% of responders (pain reduction >or= 50%), and produced 34.6 +/- 29.3 additional days with no/mild pain. Anxiety/depression symptoms decreased by -3.8 +/- 3.5 and -4.5 +/- 4.2 points (ES 0.95 and 1.02; P < 0.0001), respectively. PGB improved sleep by -17.9 +/- 19.6 points (ES 1.18; P < 0.0001) and improved patient functioning (Sheehan Disability Index) by decreasing overall scoring by -8.6 +/- 5.9 points (ES 1.59; P < 0.0001). Health state (EQ-5D) increased by 31.6 +/- 22.2 mm (ES 1.67; P < 0.0001), with 0.0388 +/- 0.0374 gained quality-adjusted life-years. In spite of the small sample size, results support the effectiveness of PGB for the improvement in pain and related health symptoms.

Topics: Analgesics; Disability Evaluation; Evidence-Based Medicine; Female; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Pain; Pregabalin; Primary Health Care; Quality of Life; Surveys and Questionnaires; Treatment Outcome; Trigeminal Neuralgia

Post-traumatic trigeminal neuropathic pain (PTNP) following trigeminal neuralgia (TN)-related neuroablative procedures is relatively rare. Due to the fear of debilitating complications, its treatment has been generally suboptimal. Pregabalin (PGB) has been reported to relieve neuropathic pain. However, the potential role of PGB and the predictors of response of PGB use as a strategy in the treatment of PTNP following TN-related neuroablative procedures have not been identified yet.. To report the efficacy and safety of PGB and the identification of predictors of PGB for PTNP following TN-related neuroablative procedures.. Monocentric, retrospective, observational study.. This study consecutively enrolled patients with PTNP following TN-related neuroablative procedures who were prescribed PGB at Beijing Tiantan Hospital.. From January 2018 to June 2022, a total of 112 patients were included in this study, of whom 10 were excluded because of incomplete follow-up data and side effects immediately after taking PGB. Final analysis included 102 patients. Demographic data, pain-related baseline data, efficacy of patients with PTNP after one month of PGB evaluated by the Barrow Neurological Institute (BNI) scores for pain, and side effects of PGB were extracted and analyzed. The predictors of pain-relieving effects of PGB were identified by logistic regression analysis.. Within one month after the use of PGB alone, 29 out of the 102 (28.4%) patients achieved pain relief with a significant reduction in the BNI scores (P < 0.01). All of the 73 patients who did not respond to PGB monotherapy either switched to other medications (n = 8) or combined additional oral medications to the existing PGB therapy (n = 65). The main side effect of PGB in our study was dizziness. Binary logistic regression analysis showed that longer disease durations (Adjusted odds ratio [OR] = 0.55, 95% confidence interval [CI] 0.43 to 0.72, P = 0.000) and higher Hospital Anxiety and Depression Scale (HADS) scores (Adjusted OR = 0.29, 95% CI 0.10 to 0.87, P = 0.022) were poor predictors of response to PGB.. This was a retrospective observational study. Long-term efficacy and safety of PGB in the treatment of PTNP patients were not evaluated.. This study confirms that PGB monotherapy is not a very effective treatment for PTNP following TN-related neuroablative procedures. PGB was more beneficial in patients with shorter disease durations and lower HADS scores.. Post-traumatic trigeminal neuropathic pain, efficacy, safety, predictor of response, pregabalin.

Topics: Humans; Neuralgia; Pregabalin; Retrospective Studies; Treatment Outcome; Trigeminal Neuralgia

It is frequently reported that neuropathic pain is associated with abnormalities in brain function and structure as well as cognitive deficits. However, the contributing mechanisms have remained elusive.. We aimed to investigate the systemic ultrastructural changes of the peripheral nervous system (PNS) and central nervous system (CNS) in rats with trigeminal neuralgia (TN) induced by cobra venom, as well as the effects and mechanisms of electroacupuncture (EA) and pregabalin (PGB) on TN.. This study used an experimental design in rats.. The research took place in the laboratory at the Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine.. Male Sprague-Dawley rats were randomly divided into 4 groups (n = 12/group): cobra venom (CV), PGB, EA, and sham-operated (SHAM). The development of pain-related behaviors and spatial learning and memory abilities were measured using video recordings and Morris water maze tests, respectively. The ultrastructural changes of the PNS and CNS were examined using transmission electron microscopy. We also screened the differentially expressed genes and proteins in the prefrontal cortex  and hippocampus using  ribonucleic acid sequencing and isobaric tag for relative and absolute quantitation techniques, respectively. Data for the behavioral tests and molecular biology were analyzed with a one-way analysis of variance.. The rats in the CV group exhibited long-lasting pain-like behaviors, cognitive deficits, and systemic ultrastructural changes. Both EA and PGB alleviated the chronic pain syndrome, but EA also inhibited the chronic pain-induced cognitive dysfunction and restored normal cellular structures, while PGB was associated with no improvements. Transcriptomic and proteomic analyses revealed marcks, pak2 and acat1 were altered in rats with TN but were adjusted back to baseline by EA but not by PGB.. We examined systemic ultrastructural alterations at different levels of the nervous system; however, the detailed timeline of the damage process was not explicitly delineated.  Moreover, the current study provides only preliminary evidence for the neurobiological mechanisms of cognitive impairment resulting from chronic pain.  Further research is still necessary (using models such as gene knockout rats and cell cultures) before a detailed mechanism can be postulated.. EA treatment may offer significant advantages when compared to PGB for the treatment of cognitive impairment associated with chronic pain. Moreover, marcks, pak2 and acat1 may be the potential therapeutic targets of EA.

Topics: Animals; Chronic Pain; Elapid Venoms; Electroacupuncture; Humans; Male; Pregabalin; Proteomics; Rats; Rats, Sprague-Dawley; Spatial Learning; Trigeminal Neuralgia

Thalamic pain is a neuropathic pain syndrome that occurs as a result of thalamic damage. It is difficult to develop therapeutic interventions for thalamic pain because its mechanism is unclear. To better understand the pathophysiological basis of thalamic pain, we developed and characterized a new rat model of thalamic pain using a technique of microinjecting cobra venom into the ventral posterolateral nucleus (VPL) of the thalamus.. This study will establish a new thalamic pain rat model produced by administration of cobra venom to the unilateral ventral posterolateral nucleus.. This study used an experimental design in rats.. The research took place in the laboratory at the Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine.. Male Sprague-Dawley rats were subjected to the administration of cobra venom or saline into the left VPL. The development of mechanical hyperalgesia and changes in pain-related behaviors and motor function were measured after intrathalamic cobra venom microinjection using the von Frey test, video recording, and cylinder test, respectively. On postoperative days 7 to 35, both electroacupuncture and pregabalin (PGB) were administered to verify that the model reproduced the findings in humans. Moreover, the organizational and structural alterations of the thalamus were examined via transmission electron microscopy (TEM).. The threshold for mechanical stimuli in the left facial skin was significantly decreased on day 3 after thalamic pain modeling as compared with pre-venom treatment. Furthermore, the ultrastructural alterations of neurons such as indented neuronal nuclei, damaged mitochondria and endoplasmic reticulum, and dissolved surrounding tissues were observed under TEM. Moreover, electroacupuncture treatment ameliorated mechanical hyperalgesia, pain-like behaviors, and motor dysfunction, as well as restore normal structures of neurons in the thalamic pain rat model. However, no such beneficial effects were noted when PGB was administered.. The pathophysiological features were different from the present model and the patients in clinical practice (in most cases strokes, either ischemic or hemorrhagic).. The cobra venom model may provide a reasonable model for investigating the mechanism of thalamic pain and for testing therapies targeting recovery and pain after thalamic lesions.. Thalamic pain, cobra venom, electroacupuncture, pregabalin, indented neuronal nuclei, damaged mitochondria, dissolved endoplasmic reticulum, golgi body.

Topics: Animals; Brain; China; Disease Models, Animal; Elapid Venoms; Electroacupuncture; Hyperalgesia; Male; Neuralgia; Pain Measurement; Pregabalin; Rats; Rats, Sprague-Dawley; Trigeminal Neuralgia; Ventral Thalamic Nuclei

Topics: Aged; Analgesics, Non-Narcotic; Carbamazepine; Dermatitis, Allergic Contact; Diagnosis, Differential; Drug Hypersensitivity Syndrome; Drug Interactions; Drug Therapy, Combination; Humans; Male; Patch Tests; Pregabalin; Syndrome; Trigeminal Neuralgia

Only few studies have investigated the effectiveness of pregabalin (PGB) treatment for trigeminal neuralgia (TN). We aimed to retrospectively analyze the effectiveness of PGB treatment in refractory TN as a salvage treatment preceding surgery. Of 61 patients with TN refractory to prior treatment with carbamazepine (CBZ), we enrolled 33 patients in our study who agreed to receive PGB before they underwent surgery. The patients were divided into effective and ineffective groups depending on the patient-reported outcome. Correlations between effectiveness and clinical characteristics such as the age, sex, disease duration, initial CBZ responsiveness, the number of patients who underwent polytherapy with PGB and CBZ, final doses of CBZ and PGB at the time of evaluation, and the etiology of the neurovascular compression were statistically analyzed. Furthermore, a linear discriminant analysis was performed to predict effectiveness. TN was improved in 16 patients (48.5%) in the PGB-treatment group but none in patients without PGB-treatment. The final dose of PGB was 166.7 mg at the mean follow-up period of 5.5 months. Our results showed that age was the only factor that significantly differed between PGB-effective and ineffective groups. A logistic regression analysis also demonstrated that among all the clinical variables considered, only older age was significantly associated with effectiveness of PGB treatment. Effectiveness was correctly predicted at a threshold value of 62.7-years-old with 69.7% reliability. We suggest that PGB is useful, even at the low-dose, as a salvage preoperative treatment for patients with refractory TN, particularly for elderly patients.

Topics: Aged; Analgesics; Female; Humans; Male; Middle Aged; Pregabalin; Preoperative Care; Salvage Therapy; Trigeminal Neuralgia

In MS patients (PwMS), paroxysmal symptoms (PS) are frequently reported and are often the cause of suffering. PS include Trigeminal Neuralgia (TN) that is the most widely recognized neurophatic pain syndrome. TN treatment primarily consists of antiepileptic medications such as Carbamazepine (CBZ) and Lamotrigine (LTG). CBZ is reported to be not well tolerated by PwMS for its side effects that mimic an MS exacerbation. Pregabalin (PGB) was successfully used in treating paroxysmal symptoms in PwMS. We performed a prospective open-label pilot study of PGB in combination with LTG in a group of MS patients with TN to evaluate the efficacy and tolerability of the two medications in subjects who were no-responsive or intolerant to conventional treatment. The combination of PGB and LTG may prove effective in the treatment of TN in PwMS, at small dosages, along with the possibility of minimizing adverse effects, while significantly improving pain control.

Topics: Aged; Anticonvulsants; Drug Therapy, Combination; Female; Humans; Lamotrigine; Male; Middle Aged; Pregabalin; Treatment Outcome; Trigeminal Neuralgia

Topics: Acyclovir; Aged; Brain Stem; Drug Therapy, Combination; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Male; Neurologic Examination; Pregabalin; Trigeminal Neuralgia; Trigeminal Nucleus, Spinal

A 48-year old woman in good general health was referred to the orofacial pain clinic in a centre for special dentistry with a toothache in the premolar region of the left maxillary quadrant. The complaints had existed for 15 years and various dental treatments, including endodontic treatments, apical surgery, extraction and splint therapy, had not helped to alleviate the complaints. As a result of the fact that anti-epileptic drugs were able to reduce the pain it was concluded that this 'toothache' satisfied the criteria of an atypical odontalgia: 'toothache' with a neuropathic background.. Een 48-jarige vrouw in goede algemene gezondheid presenteerde zich op de afdeling Gnathologie van een centrum voor bijzondere tandheelkunde met pijnklachten in het tweede kwadrant. De klachten bestonden reeds 15 jaar en diverse tandheelkundige behandelingen, waaronder endodontische behandelingen, chirurgische apicale endodontische behandeling, extractie en de vervaardiging van een stabilisatieopbeetplaat, hadden niet geholpen. Uit het feit dat een anti-epilepticum de pijn deed afnemen, werd geconcludeerd dat er sprake was van atypische odontalgie: ‘kiespijn’ met een neuropathische achtergrond.

Topics: Analgesics; Chronic Pain; Diagnosis, Differential; Female; Humans; Middle Aged; Pregabalin; Toothache; Treatment Outcome; Trigeminal Neuralgia

To evaluate pharmacotherapeutic success in patients with painful traumatic trigeminal neuropathy (PTTN) and to identify patient or pain characteristics that may predict treatment outcome.. Pharmacotherapy was instituted for PTTN patients and was based on widely accepted protocols for neuropathic pain and conducted in an open fashion. Outcome was assessed by employing prospective diaries recording pain intensity measured with an 11-point (0 to 10) verbal pain score (VPS). Individual characteristics in the patients and their influence on outcome were analyzed. Treatment results in the PTTN patients were compared with those in classical trigeminal neuralgia (CTN) patients, who were used as a comparative cohort. Data were analyzed with a Pearson chi-square test for nominal variables and with an independent samples t test or analysis of variance for continuous variables.. A total of 145 patients were included: 91 with PTTN and 54 with CTN. In PTTN patients, 11% had a ≥ 50% reduction in pain intensity. Higher VPS scores in the PTTN patients were associated with a significantly reduced response to therapy (P = .03). No other pain-related or demographic parameters were associated with treatment outcome in the PTTN patients. Also the response rate of PTTN patients was significantly inferior to that of CTN patients, 74.1% of whom attained a significant reduction in pain intensity (P < .001).. This study underpins the poor pharmacotherapeutic prognosis of PTTN. The results support findings on neuropathic pain in other sites and point to the need for further research and reexamination of current PTTN treatment protocols.

Topics: Amines; Amitriptyline; Analgesics; Analgesics, Non-Narcotic; Baclofen; Carbamazepine; Clinical Protocols; Cohort Studies; Cyclohexanecarboxylic Acids; Drug Combinations; Duloxetine Hydrochloride; Female; Follow-Up Studies; GABA-B Receptor Agonists; Gabapentin; gamma-Aminobutyric Acid; Humans; Male; Medical Records; Middle Aged; Nortriptyline; Pain; Pain Measurement; Pregabalin; Prognosis; Prospective Studies; Thiophenes; Treatment Outcome; Trigeminal Nerve Injuries; Trigeminal Neuralgia

To assess the analgesic effect of pregabalin in orofacial models of acute inflammatory pain and of persistent pain associated with nerve injury and cancer, and so determine its effectiveness in controlling orofacial pains having different underlying mechanisms.. Orofacial capsaicin and formalin tests were employed in male Wistar rats to assess the influence of pregabalin (or vehicle) pretreatment in acute pain models, and the results from these experiments were analyzed by one-way analysis of variance (ANOVA) followed by Newman Keuls post-hoc test. Pregabalin (or vehicle) treatment was also tested on the facial heat hyperalgesia that was evaluated in rats receiving injection of the inflammatory irritant carrageenan into the upper lip, as well as after constriction of the infraorbital nerve (a model of trigeminal neuropathic pain), or after inoculation of tumor cells into the facial vibrissal pad; two-way repeated measures ANOVA followed by Newman-Keuls post-hoc test was used to analyze data from these experiments.. Facial grooming induced by capsaicin was abolished by pretreatment with pregabalin at 10 and 30 mg/kg. However, pregabalin failed to modify the first phase of the formalin response, but reduced the second phase at both doses (10 and 30 mg/kg). In addition, treatment of rats with pregabalin reduced the heat hyperalgesia induced by carrageenan, as well as by nerve injury and facial cancer.. Pregabalin produced a marked antinociceptive effect in rat models of facial inflammatory pain as well as in facial neuropathic and cancer pain models, suggesting that it may represent an important agent for the clinical control of orofacial pain.

Topics: Acute Pain; Analgesics; Animals; Anti-Inflammatory Agents; Capsaicin; Carrageenan; Chronic Pain; Disease Models, Animal; Facial Neoplasms; Facial Pain; gamma-Aminobutyric Acid; Hot Temperature; Hyperalgesia; Irritants; Lip Diseases; Male; Neoplasm Transplantation; Orbit; Pain Measurement; Pregabalin; Random Allocation; Rats, Wistar; Sensory System Agents; Trigeminal Neuralgia

Pregabalin is effective in treating many neuropathic pain conditions. However, the mechanisms of its analgesic effects remain poorly understood. The aim of the present study was to determine whether pregabalin suppresses facial mechanical hypersensitivity and evoked glutamate release in the medullary dorsal horn (MDH) in a rodent model of trigeminal neuropathic pain. Nociceptive mechanical sensitivity was assessed pre-operatively, and then post-operatively 1h following pregabalin or vehicle (saline) treatment on post-operative days 2 and 5 following infraorbital nerve transection (IONX). In addition, an in vivo microdialysis probe was inserted into the exposed medulla post-operatively and dialysate samples were collected. Glutamate release was then evoked by mustard oil (MO) application to the tooth pulp, and the effects of pregabalin or vehicle were examined on the MDH glutamate release. Glutamate concentrations in the dialysated samples were determined by HPLC, and data analyzed by ANOVA. IONX animals (but not control animals) showed facial mechanical hypersensitivity for several days post-operatively. In addition, tooth pulp stimulation with MO evoked a transient release of glutamate in the MDH of IONX animals. Compared to vehicle, administration of pregabalin significantly attenuated the facial mechanical hypersensitivity as well as the MO-evoked glutamate release in MDH. This study provides evidence in support of recent findings pointing to the usefulness of pregabalin in the treatment of orofacial neuropathic pain.

Topics: Analgesics; Analysis of Variance; Animals; Chromatography, High Pressure Liquid; Data Interpretation, Statistical; Dental Pulp; Facial Pain; gamma-Aminobutyric Acid; Glutamic Acid; Male; Mediodorsal Thalamic Nucleus; Mice; Mice, Inbred C57BL; Microdialysis; Mustard Plant; Neuralgia; Physical Stimulation; Plant Oils; Pregabalin; Rats; Rats, Sprague-Dawley; Trigeminal Neuralgia

Pain arising from surgical procedures that damage the inferior alveolar nerve typically responds poorly to classic therapies. The present case reports the successful medical treatment of this problem with a 10-day course of a corticosteroid and a concomitant 30-day course of an anticonvulsant.

Topics: Adrenal Cortex Hormones; Anticonvulsants; Diagnosis, Differential; Drug Therapy, Combination; Female; gamma-Aminobutyric Acid; Humans; Mandible; Middle Aged; Postoperative Complications; Prednisone; Pregabalin; Radiography, Panoramic; Tomography, X-Ray Computed; Tooth Extraction; Trigeminal Neuralgia

Topics: Aged; Analgesics; Female; gamma-Aminobutyric Acid; Humans; Pregabalin; Rhabdomyolysis; Trigeminal Neuralgia

The aim of this study was to determine whether pregabalin affects nociceptive behavior and central sensitization in a trigeminal neuropathic pain model. A partial infraorbital nerve transection (p-IONX) or sham operation was performed in adult male rats. Nociceptive withdrawal thresholds were tested with von Frey filaments applied to the bilateral vibrissal pads pre- and postoperatively. On postoperative day 7, the behavioral assessment was conducted before and at 30, 60, 120, and 180 minutes after and 24 hours after pregabalin (.1, 1, 10, 100 mg/kg intraperitoneally) or saline injection. The effects of pregabalin or saline were also examined on the mechanoreceptive field and response properties of nociceptive neurons recorded in the medullary dorsal horn at postoperative days 7 to 10. Reduced withdrawal thresholds reflecting bilateral mechanical allodynia were observed in p-IONX rats until postoperative day 28, but not in sham-operated rats. At postoperative day 7, pregabalin significantly and dose-dependently reversed the reduced mechanical withdrawal thresholds in p-IONX rats. Pregabalin also attenuated central sensitization of the neurons, as reflected in reversal of their reduced activation threshold, increased responses to pinch/pressure, and enhanced stimulus-response function. This study provides the first documentation that pregabalin attenuates the mechanical allodynia and central sensitization that characterize this trigeminal neuropathic pain model, and supports its clinical use for treating craniofacial neuropathic pain.. Trigeminal nerve injury in rats produced facial mechanical hypersensitivity and trigeminal central sensitization of medullary dorsal horn neurons that were markedly attenuated by systemically administered pregabalin, suggesting its potential clinical utility for orofacial neuropathic pain.

Topics: Analgesics; Animals; Behavior, Animal; Cranial Nerve Injuries; Electric Stimulation; Facial Pain; gamma-Aminobutyric Acid; Hot Temperature; Male; Nociception; Nociceptors; Pain Threshold; Physical Stimulation; Posterior Horn Cells; Pregabalin; Rats; Rats, Sprague-Dawley; Trigeminal Neuralgia; Vibrissae

The purpose of this study is to analyze the effect of pregabalin (PGB) on pain alleviation, use of health care and non-health care resources, and associated costs in patients with trigeminal neuralgia under usual clinical practice in primary care settings. Sixty-five PGB-naïve patients receiving PGB as monotherapy (n = 36, 55%) or combined with other drugs (n = 29, 45%) fulfill criteria for inclusion in a secondary analysis from a 12-week, multicenter, observational prospective study aimed to ascertain the cost of illness in subjects with neuropathic pain. Pain is evaluated using the Short Form McGill Pain Questionnaire. Use of health care and non-health care resources and lost workdays equivalents (LWDEs) are also recorded. PGB significantly reduces pain scores, use of health care resources (ancillary tests and unscheduled medical visits), and number of LWDEs. Additional cost of PGB treatment (+euro 174 +/- 106) is broadly compensated for by a reduction in both health care costs (-euro 621 +/-1211, P < .001) and indirect costs (-euro 1210 +/- 1141, P < .001). It is concluded that PGB as monotherapy or combined with other drugs is effective in pain management in patients with trigeminal neuralgia and reduces the cost of illness.

Topics: Absenteeism; Analgesics; Drug Therapy, Combination; Family Practice; Female; gamma-Aminobutyric Acid; Health Care Costs; Health Resources; Humans; Male; Middle Aged; Pain Measurement; Pregabalin; Prospective Studies; Trigeminal Neuralgia

Topics: Aged; Amines; Analgesics, Opioid; Anticonvulsants; Autonomic Nervous System; Cyclohexanecarboxylic Acids; Gabapentin; gamma-Aminobutyric Acid; Headache; Humans; Ketorolac; Male; Pregabalin; Tramadol; Trigeminal Neuralgia

Topics: Analgesics; gamma-Aminobutyric Acid; Humans; Pregabalin; Trigeminal Neuralgia

This prospective, open-label study aimed to evaluate the efficacy of pregabalin treatment in patients suffering from trigeminal neuralgia with and without concomitant facial pain. Fifty-three patients with trigeminal neuralgia (14 with concomitant chronic facial pain) received pregabalin (PGB) 150-600 mg daily and were prospectively followed for 1 year. The primary outcome was number of patients pain free or with reduction of pain intensity by > 50% and of attack frequency by > 50% after 8 weeks. Secondary outcome was sustained pain relief after 1 year. Thirty-nine patients (74%) improved after 8 weeks with a mean dose of 269.8 mg/day (range 150-600 mg/day) PGB: 13 (25%) experienced complete pain relief and 26 (49%) reported pain reduction > 50%, whereas 14 (26%) did not improve. Patients without concomitant facial pain showed better response rates (32 of 39, 82%) compared with patients with concomitant chronic facial pain (7 of 14, 50%, P = 0.020). Concomitant chronic facial pain appears to be a clinical predictor of poor treatment outcome. PGB appears to be effective in the treatment of trigeminal neuralgia.

Topics: Adult; Aged; Aged, 80 and over; Analgesics; Chronic Disease; Dose-Response Relationship, Drug; Facial Pain; Female; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Pregabalin; Prospective Studies; Time Factors; Treatment Outcome; Trigeminal Neuralgia