Trigeminal Neuralgia relief

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Fosphenytoin Eases Acute Trigeminal Neuralgia Pain

April 19, 2025

Intravenous fosphenytoin effectively reduces pain in patients with acute trigeminal neuralgia (TN), according to a phase 3 trial conducted in Japan. The study involved 21 patients with TN, showing significant pain reduction two hours post-administration compared to placebo. Fosphenytoin also decreased the frequency of TN attacks before the next maintenance dose. The trial used a numerical rating scale (NRS) from 0 (no pain) to 10 (most severe pain), with active treatment reducing scores from 7 to 0.8. Common side effects included somnolence and decreased blood pressure, but these were generally well-tolerated. The study highlights the need for fast-acting treatments for TN, especially when surgical options are delayed. Fosphenytoin, already used off-label in Japan, may serve as an effective bridging therapy for patients awaiting more definitive treatments.

The Takeaway:Fosphenytoin offers rapid relief for acute trigeminal neuralgia pain.

--MDedge -- Neurology