Subcutaneous sumatriptan for refractory trigeminal neuralgia

Akifumi Kanai, Miwako Saito, Sumio Hoka

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background. - Mechanical compression of the trigeminal root by an artery is thought to cause trigeminal neuralgia. The 5-HT1B/1D receptor agonist may inhibit neurogenic inflammation and vasodilation near the irritated trigeminal root. Objective. - To examine the effectiveness of a 5-HT 1B/1D receptor agonist, sumatriptan, on a paroxysmal pain in trigeminal neuralgia. Methods. - Twenty-four patients with trigeminal neuralgia refractory to previous treatment were randomized to receive subcutaneously either 3 mg (1 mL) of sumatriptan or 1 mL of saline placebo. Following a 7-day period, patients crossed over to receive the alternative treatment. Paroxysmal pain triggered by touching or moving the face was assessed with VAS before and 15 minutes after the treatment. Patients used a descriptive scale to pain-grade outcome, and asked to note whether the pain returned and how long after therapy it recurred. Results. - Subcutaneous sumatriptan, but not placebo, significantly decreased VAS from 8.3 ± 2.1 to 2.4 ± 3.0 cm (mean ± SD). The number of patients who described their pain as moderately or slightly better was 20 in the sumatriptan group and 1 in the placebo group. The effect of subcutaneous sumatriptan persisted for a median period of 7.9 hours (range: 1-20 hours). Conclusions. - Subcutaneous sumatriptan produced prompt analgesia without serious adverse reactions in patients with trigeminal neuralgia refractory to previous treatment.

Original languageEnglish
Pages (from-to)577-582
Number of pages6
JournalHeadache
Volume46
Issue number4
DOIs
Publication statusPublished - Apr 1 2006

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Sumatriptan
Trigeminal Neuralgia
Pain
Receptor, Serotonin, 5-HT1B
Placebos
Receptor, Serotonin, 5-HT1D
Neurogenic Inflammation
Therapeutics
Vasodilation
Analgesia
Arteries

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Subcutaneous sumatriptan for refractory trigeminal neuralgia. / Kanai, Akifumi; Saito, Miwako; Hoka, Sumio.

In: Headache, Vol. 46, No. 4, 01.04.2006, p. 577-582.

Research output: Contribution to journalArticle

Kanai, Akifumi ; Saito, Miwako ; Hoka, Sumio. / Subcutaneous sumatriptan for refractory trigeminal neuralgia. In: Headache. 2006 ; Vol. 46, No. 4. pp. 577-582.
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