Diagnostic significance of carbamazepine and trigger zones in trigeminal neuralgia.
OBJECTIVE
To investigate the relationship between the efficacy of carbamazepine (CBZ) and the presence of the trigger zone for diagnosis of trigeminal neuralgia (TN). Study design CBZ was administered to 61 patients with suspected TN. All patients underwent intracranial examination by magnetic resonance imaging or computed tomography. The final diagnosis was established by oral and maxillofacial surgeon and neurosurgeon.


RESULTS
Of the 61 patients, 50 were finally diagnosed as having TN and 6 as having atypical facial pain. CBZ was effective for pain relief in 45 of the 50 TN patients (90%), and in 5 of the 11 patients (45%) with other diseases (P <.005). However, CBZ also relieved pain in some patients other than TN. Thirty of the 31 patients (97%) with a distinct trigger zone and 20 of the 30 (67%) without a trigger zone were diagnosed as having TN (P<0.005).


CONCLUSIONS
The efficacy of CBZ is an auxiliary indicator of TN and the presence of a distinct trigger zone is a strong indicator of TN.
Sato
Jun
J
Department of Oral and Maxillofacial Surgery, Kanazawa Medical University, Japan. jun-s@kanazawa-med.ac.jp
Saitoh
Tohru
T
Notani
Ken-Ichi
K
Fukuda
Hiroshi
H
Kaneyama
Keiseki
K
Segami
Natsuki
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic; D002220:Carbamazepine; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005157:Facial Pain / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009443:Neuritis / Q000175:diagnosis; D011671:Pulpitis / Q000175:diagnosis; D012189:Retrospective Studies; D012852:Sinusitis / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis; D014277:Trigeminal Neuralgia / Q000175:diagnosis* / Q000503:physiopathology
D018712:Analgesics, Non-Narcotic; D002220:Carbamazepine