title: Effect of 5% lidocaine medicated plaster on pain intensity and paroxysms in classical trigeminal neuralgia.
abstract: OBJECTIVE
  Trigeminal neuralgia (TN) is a neuropathic pain condition affecting one or more branches of the trigeminal nerve. It is characterized by unilateral, sudden, shock-like, and brief painful attacks, which follow the distribution of trigeminal nerve branches, and with no other accompanying sensorimotor or autonomic signs and symptoms. Current guidelines stipulate which therapies represent first-, second-, and third-line treatments for TN, but there is a consistent mismatch between the therapeutic guidelines and the patient's preferences and expectations.
  
  
  METHODS
  We report on 2 patients with classical TN in whom conventional drugs for TN were not tolerated. In these patients, treatment with 5% lidocaine medicated plaster (LMP) resulted in reduction of pain intensity and the number of pain paroxysms.
  
  
  CONCLUSIONS
  LMP is known to block the sodium channels on peripheral nerves and may cause a selective and partial block of Aδ and C fibers. According to the TN ignition hypothesis, blockage of peripheral afferents by LMP may reduce pain paroxysms. The effect of LMP may outlast the pharmacokinetics of the drug by reducing pain amplification mechanisms in the central nervous system. LMP has limited or no systemic side effects.
  
  
  CONCLUSIONS
  LMP may be an effective and well-tolerated treatment option for TN in those patients who do not tolerate or who refuse other therapies. Future randomized controlled studies should better address this issue.
authors: University of Verona, Verona, Italy stefano.tamburin@univr.it.
authors: Stefano
authors: S
authors: Tamburin
authors: University of Verona, Verona, Italy.
authors: Vittorio
authors: V
authors: Schweiger
authors: University of Verona, Verona, Italy.
authors: Francesca
authors: F
authors: Magrinelli
authors: University of Verona, Verona, Italy.
authors: Maria Paola
authors: MP
authors: Brugnoli
authors: Pederzoli Hospital, Peschiera del Garda, Verona, Italy.
authors: Giampietro
authors: G
authors: Zanette
authors: University of Verona, Verona, Italy.
authors: Enrico
authors: E
authors: Polati
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D009437:Neuralgia / Q000188:drug therapy* / Q000503:physiopathology; D014277:Trigeminal Neuralgia / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: analgesia; central nervous system; headache; neurology; pain management