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Subcutaneous Sumatriptan for Refractory
Trigeminal Neuralgia
Akifumi Kanai MD, Miwako Saito MD, Sumio Hoka MD.
Posted: May 2006  
Headache 2006;46:577-582

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.