FACIAL PAIN TREATED WITH CARBAMAZEPIN (TEGRETOL®)

Abstract

The effect of Tegretol has been investigated in 71 patients with facial pain, using a single blind technique. Tegretol was found to have an immediate good effect in 83 per cent of patients with typical trigeminal neuralgia, in 87 per cent of those with atypical neuralgia, and in 53 per cent of those with non-neuralgiform facial pain. Pain disappeared within the first 24 hours of treatment in 69 per cent and within the following 24 hours in a further 24 per cent. The 54 patients with a good immediate effect of Tegretol continued to take the drug after discharge, and 69 per cent of these were free of pain for over two years. Complications made withdrawal of treatment necessary in 5 per cent of the patients. One patient developed cardiac pain, three rash, three headache, nausea and vomiting, and two dizziness. Tegretol acts by reducing the bulbar and spinal polysynaptic reflexes. It has a central action, in particular on the reticulo-thalamic system. Our present knowledge of the mode of action of Tegretol supports the hypothesis that trigeminal neuralgia is due to pathological multineuronal reflexes in the trigeminal system on the level spinal trigeminal nuclei-thalamus.