Tegretol* in the treatment of trigeminal neuralgia in thirty patients

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THE earliest known description of a painful affliction of the face which might be considered as trigeminal neuralgia, according to Stookey and Ransohoff,1 is found in the writings of Aretaeus in the first century A.D., and the first full description by a physician of tic douloureux together with an account of his treatment is that by Locke. In 1776, Fothergill2 reported 14 cases of facial pain that was typical trigeminal neuralgia.

The medical treatment of this disease has been disappointing since the entity was first described. In recent years, anticonvulsants have been advocated as therapy for trigeminal neuralgia.3–7 Blom5 contended that diphenylhydantoin, in addition to its anticonvulsant properties, affects synaptic transmission at levels caudal to the mesencephalon, and on this basis he has used the drug in the treatment of tic douloureux. The beneficial effects have generally been confirmed,8–13 however results with this drug are variable. Administered in low doses, diphenylhydantoin often is ineffective, while the high dosages sometimes necessary to control symptoms are poorly tolerated.

Blom3 and others6–8, 14–23 have reported their experience with Tegretol in the treatment of trigeminal neuralgia. The results have been most promising in that the drug produced a consistent decrease in painful paroxysms and was tolerated well by most patients. Our report is an evaluation of our experience using Tegretol in the treatment of trigeminal neuralgia in 30 patients.

Materials and methods

Tegretol was administered to a total of 36 patients, of whom 30 had trigeminal neuralgia. The other six patients had atypical facial . . .



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