Case report: successful treatment of a patient with trigeminal neuropathy using ziconotide.
A 50-year-old female patient with chronic neuropathic pain in the distribution of the second branch of the trigeminal nerve was unsuccessfully treated over several years. Intrathecal therapy with ziconotide was administered at an initial dose of 0.33 microg/d, which was gradually increased by 0.7 microg/d. Subjective pain on the numeric rating scale was reduced from 9/10 to 3-4/10 at a dose of 6.3 microg/d. Long-term treatment was continued at a ziconotide concentration of 12.5 microg/mL and a daily dose of 3.9 microg/d by a SynchroMed Infusion System (Medtronic, Minneapolis, MN). Pain reduction was maintained in the follow-up observation period over 5 months.
Lux
Eberhard Albert
EA
Clinic of Pain and Palliative Medicine, St.-Marien-Hospital, Lünen, Germany. drlux@web.de
D000639:Amitriptyline / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D053961:Azabicyclo Compounds / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007278:Injections, Spinal; D008134:Long-Term Care; D008875:Middle Aged; D010147:Pain Measurement; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy; D010879:Piperazines / Q000627:therapeutic use; D014277:Trigeminal Neuralgia / Q000188:drug therapy*; D020960:omega-Conotoxins / Q000008:administration & dosage / Q000627:therapeutic use*
D000700:Analgesics; D000929:Antidepressive Agents, Tricyclic; D053961:Azabicyclo Compounds; D002121:Calcium Channel Blockers; D006993:Hypnotics and Sedatives; D010879:Piperazines; D020960:omega-Conotoxins; C515050:zopiclone; D000639:Amitriptyline; C078452:ziconotide