An observational trial to investigate the efficacy and tolerability of levetiracetam in trigeminal neuralgia.
OBJECTIVE
To explore the efficacy and tolerability of levetiracetam in medical treatment of trigeminal neuralgia.


BACKGROUND
Antiepileptic drugs (AEDs) are considered as first-line treatment for trigeminal neuralgia, although their use is often limited due to incomplete efficacy and tolerability. Newer AEDs with improved safety profile may be useful in this disorder.


METHODS
Patients suffering from trigeminal neuralgia (either primary or secondary) refractory to previous treatments were recruited to be treated with levetiracetam (3-4 g/day) for 16 weeks as add-on therapy, after a 2-week baseline period. Rescue medication was allowed in both the baseline and treatment phases. The primary efficacy measure was the number of attacks per day. The patients' efficacy evaluation, the patients' global evaluation for both safety and efficacy, changes in the Hamilton Depression Scale, the Hamilton Anxiety Scale, and the Quality of Life Measure Short Form-36 were secondary parameters.


RESULTS
Twenty-three patients were included in the analysis. After treatment and compared to the baseline phase, the number of daily attacks decreased by 62.4%. All secondary parameters changed significantly with the exception of the Quality of Life Measure Short Form-36 score. Seven patients withdrew from the study. Five patients (21.7%) reported side effects and 2 withdrew.


CONCLUSIONS
Levetiracetam may be effective and safe in trigeminal neuralgia treatment. Confirmation in a randomized controlled study is needed.
Athens Naval Hospital, Neurology Department, Athens, Greece.
Dimos D
DD
Mitsikostas
George V
GV
Pantes
Theodore G
TG
Avramidis
Klimentini E
KE
Karageorgiou
Stylianos D
SD
Gatzonis
Pantelis G
PG
Stathis
Vassiliki A
VA
Fili
Anna D
AD
Siatouni
Michail
M
Vikelis
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010889:Piracetam / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011446:Prospective Studies; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000188:drug therapy*; D055815:Young Adult
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam