title: Refractory trigeminal neuralgia responsive to nabiximols in a patient with multiple sclerosis.
abstract: BACKGROUND
  Nabiximols is a cannabinoid compound approved for the treatment of multiple sclerosis (MS)-related spasticity. However, additional symptoms, such as pain, urinary urgency and sleep disturbance, may benefit from treatment.
  
  
  METHODS
  The present report describes a patient with secondary progressive MS and severe lower limbs spasticity who was started on treatment with nabiximols. The patient also suffered from trigeminal neuralgia, which he was not treating due to inefficacy or side effects of all previously tried medications. After nabiximols initiation the patient experienced a marked benefit on trigeminal neuralgia, which completely resolved, while spasticity responded only partially to treatment.
  
  
  CONCLUSIONS
  Nabiximols mechanism of action is based on the interaction with CB1 and CB2 receptors, which are expressed by central nervous system neurons and are known to modulate pain among other effects. The present case indicates that nabiximols and other cannabinoids need to be further tested for the treatment of trigeminal neuralgia.
authors.affiliation: Department of Neurological, Biomedical and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy. Electronic address: alberto.gajofatto@univr.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Gajofatto
mesh_terms: D002185:Cannabidiol / Q000627:therapeutic use*; D063385:Cannabinoid Receptor Modulators / Q000627:therapeutic use*; D013759:Dronabinol / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000188:drug therapy / Q000503:physiopathology; D014277:Trigeminal Neuralgia / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D063385:Cannabinoid Receptor Modulators; D004338:Drug Combinations; D009125:Muscle Relaxants, Central; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols
keywords: Cannabinoids; Multiple sclerosis; Sativex®; Spasticity; Trigeminal neuralgia