title: Lamotrigine therapy for resistant pain in radicular lesions of cervical segments C4-C5 and C5-C6: a case report.
abstract: Radicular pain syndromes caused by disk herniation are often accompanied by incomplete central cord syndrome. Intensive pain is difficult to control with standard analgesics. Antiepileptics of new generation have shown significant efficacy in treating pain syndromes, trigeminal neuralgia, diabetic neuropathy, migraines, etc. The treatment of radicular pain with lamotrigine, a new generation antiepileptic, turned out to be effective in lumbar disk radicular conflicts, justifying its application for resistant pain in cervical segment. In our patient, pain intensity was significantly reduced with gradual titration of lamotrigine to a dose of 200 mg/day. Pain intensity measured by the visual analog scale significantly decreased from 100 to 20 mm during eight weeks of titration. The blood concentration of the drug measured by the method of high performance liquid chromatography was 13.65 micromol/L. The patient's quality of life improved greatly. It is necessary to further evaluate the efficacy of lamotrigine in the treatment of resistant radicular damage.
authors.affiliation: University Department of Neurology, Split University Hospital Center, Split, Croatia. marina.titlic@gmail.com
authors.forename: Marina
authors.initials: M
authors.lastname: Titlić
authors.forename: Ivana
authors.initials: I
authors.lastname: Jukić
authors.forename: Ante
authors.initials: A
authors.lastname: Tonkić
authors.forename: Ante
authors.initials: A
authors.lastname: Buca
authors.forename: Anka
authors.initials: A
authors.lastname: Aleksić-Shihabi
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications*; D000077213:Lamotrigine; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D011843:Radiculopathy / Q000209:etiology*; D014227:Triazines / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine