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Subcutaneous Sumatriptan for Refractory
Akifumi Kanai MD, Miwako Saito MD, Sumio Hoka MD.
Posted: May 2006
Background: Mechanical compression of the
trigeminal root by an artery is thought to cause trigeminal neuralgia.
Objective: To examine the effective of sumatriptan on a
paroxysmal pain n trigeminal neuralgia.
Methods: Twenty-four patients with trigeminal neuralgia
refractory to previous treatment were randomized to receive subcutaneously
either 3 mg. or 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
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: 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.
Conclusions: Subcutaneous sumatriptan produced prompt analgesia
without serious adverse reactions in patients with trigeminal neuralgia refractory
to previous treatment.