Relationship between the curative effects of carbamazepine administration and the neurovascular compression volume of the trigeminal nerve measured using magnetic resonance cisternography.
OBJECTIVE
To elucidate the relationship between the extent of pain and neurovascular compression (NVC) volume, measured by magnetic resonance (MR) cisternography, in patients with trigeminal neuralgia. In addition, we aimed to evaluate the relationship between NVC volume and the efficacy of carbamazepine administration in patients with trigeminal neuralgia.


METHODS
MR cisternography was performed on 214 patients with clinical signs and symptoms that suggested trigeminal neuralgia retrospectively. The extent of their pain was evaluated using visual analog scales. Next, only carbamazepine was administered as the initial treatment. For the patients with NVC detectable on MR cisternography, the relationship between the extent or nature of the pain and the neurovascular volume was analyzed. In addition, the correlation between the efficacy of carbamazepine treatment and the NVC volume was evaluated retrospectively.


RESULTS
Of the 214 patients evaluated, 144 were deemed to have NVC. In these 144 patients, a significant difference was found between the NVC volume and the curative effects of 100 mg/d carbamazepine. However, no significant correlation was found between the extents of pain by visual analog score or between the daily dosage of carbamazepine and the NVC volume measured by MR cisternography.


CONCLUSIONS
Three-dimensional MR cisternography is very useful for detecting the site of NVC in patients with trigeminal neuralgia. NVC measured by this technique may indicate the prognosis after initial treatment. The present results suggest that the evaluation of NVC volume by MR cisternography would be useful in choosing the initial treatment for patients with trigeminal neuralgia.
Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Japan.
Tatsurou
T
Tanaka
Eiji
E
Sakamoto
Shunji
S
Shiiba
Masafumi
M
Oda
Shinji
S
Kito
Nao
N
Wakasugi-Sato
Shinobu
S
Matsumoto-Takeda
Yoshiki
Y
Imamura
Osamu
O
Nakanishi
Yasuhiro
Y
Morimoto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D002220:Carbamazepine / Q000008:administration & dosage*; D002533:Cerebral Angiography / Q000379:methods; D002561:Cerebrovascular Disorders / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D014276:Trigeminal Nerve / Q000473:pathology*; D014277:Trigeminal Neuralgia / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D055815:Young Adult
D018712:Analgesics, Non-Narcotic; D002220:Carbamazepine