[en] The prophylactic management of recurrent head and facial pains may be challenging because of lack of efficacy and/or bothersome adverse effects of available drug therapies. New generation antiepileptic drugs offer new perspectives in difficult cases. We will review the available published data and present our experience with lamotrigine in various head and facial pains such as migraine, cluster headache, neuropathic trigeminal pain, atypical facial pain, and chronic tension-type headache. Twenty-five patients were enrolled and followed for 18 months. The dose was gradually increased in steps of 25 mg up to the effective dose (mean 250 mg/d). Lamotrigine was most effective in trigeminal neuralgia and dysesthesia, but was of little utility in the other head or facial pains.
Disciplines :
Neurology Neurosciences & behavior
Author, co-author :
DELVAUX, Valérie ; Centre Hospitalier Universitaire de Liège - CHU > Neurologie Sart Tilman
Schoenen, Jean ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Neuro-anatomie
Language :
English
Title :
New generation antiepileptics for facial pain and headache
Canavero, Bonicalzi, V., Lamotrigine control of trigeminal neuralgia: An expanded study (1997) J. Neurol., 244, pp. 527-532
Cerbo, R., De Matteis, G., Barbanti, P., Di Gianfieippo, G., Carolei, A., Is gabapentin effective in the treatment of drug resistant migraine (1997) J. Neurol. Sci., 150 (SUPPL.), pp. S103
Cummins, T.R., Dib-Hajj, S.D., Beack, J.A., Waxman, S.G., Sodium channels and the molecular pathophysiology of pain (2000) Progr. Brain Res., 129, pp. 3-19
D'Andrea, G., Granella, F., Cadaldini, M., Manzoni, G.C., Effectiveness of lamotrigine in the prophylaxis of migraine with aura : An open pilot study (1999) Cephalalgia, 19, pp. 64-66
Di Trapani, G., Mei, D., Marra, C., Mazza, S., Capuano, A., Gabapentin in the prophylaxis of migraine : A double-blind , randomized, placebo-controlled study (2000) Cephalalgia, 20 (197), p. 345
Edwards, K.R., Glantx, M.J., Norton, J.A., Cross, N., Prophylactic treatment of episodic migraine with topiramate : A double-blind, placebo-controlled trial in 30 patients (2000) Cephalalgia, 20 (126), p. 316
Freitag, F.G., Diamond, S., Diamond, M.L., Tiagabine in the propylaxis of migraine (1999) Neurology, 52 (2 SUPPL.), pp. A208. , P03.048
Goadsby, P.J., Migraine, aura, and cortical spreading depression : Why are we still talkin about it ? (2001) Ann. Neurol., 49, pp. 4-6
Haan, J., Sluis, P., Sluis, L.H., Ferrari, M., Acetazolamide treatment for migraine aura status (2000) Neurology, 55, pp. 1588-1589
Haugh, M.J., Connor, G.S., Favourable response of trigeminal neuralgia to the anticonvulsant topiramate : A retrospective study (2000) Cephalalgia, 20 (284), p. 379
Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain (1988) Cephalalgia, 8 (7 SUPPL.), pp. 1-90
Lauritzen, M., Pathophysiology of the migraine aura. The spreading depression theory (1994) Brain, 117, pp. 199-200
Leandri, M., Lunardi, G., Inlgese, M., Messmer-Ucceei, M., Mancardi, G.L., Lamotrigine in trigeminal neuralgia secondary to multiple sclerosis (2000) J. Neurol., 247, pp. 556-558
Lenaerts, M., Bastings, E., Sianard, J., Schoenen, J., Sodium valproate in severe migraine and tensiontype headache : An open study of long-term efficacy and correlation with blood levels (1996) Acta Neurologica Belgica, 96, pp. 126-129
Lunardi, G., Leandri, M., Albano, C., Cultrera, S., Fracossi, M., Clinical effectiveness of lamotrigine and plasma levels in essential and symptomatic trigeminal neuralgia (1997) Neurology, 48, pp. 1714-1717
Mathew, N.T., Valproate in intractable headache (1994) Cephalalgia, 14, pp. 182-188
Merren, M.D., Gabapentin for treatment of pain and tremor : A large case series (1998) Southern Medical Journal, 91, pp. 739-744
Mitsikostas, D.D., The valproate mechanisms of action in migraine (1994) Cephalalgia, 14, p. 465
Potter, D.L., Hart, D.E., Calder, C.S., Storey, J.R., A double-blind, randomized, placebo-controlled study of topiramate in the prophylactic treatment of migraine with and without aura (2000) Cephalalgia, 20 (97), p. 305
Rowbotham, M., Harden, N., Stacey, B., Bernstein, P., Magnus-Miller, L., Gabapentin for the treatment of postherpetic neuralgia : A randomized controlled trial (1998) JAMA, 280, pp. 1837-1842
Scheller, D., Heister, U., Dengler, K., Tegtmeier, F., Extracellular changes of aspartate and glutamate during generation and during propagation of cortical spreading depression in rats (1991) Migraine and Other Headaches : The Vascular Mechanisms, pp. 161-165. , Olesen J. (ed.). New York, Raven Press
Sist, T.H., Filadora, V., Miner, M., Lema, M., Gabapentin for idiopathic trigeminal neuralgia : Report of two cases (1997) Neurology, 48, pp. 1467-1471
Steiner, T.J., Findley, L.J., Yuen, A.W.C., Lamotrigine versus placebo in the prophylaxis of migraine with and without aura (1997) Cephalalgia, 17, pp. 109-112
Valzania, F., Strafella, A.P., Nassetti, S.A., Tropeani, A., Tassinari, C.A., Gabapentin in idiopathic trigeminal neuralgiaet (1998) Neurology, 50 (4 SUPPL.), pp. A379. , P06.012
Von Seggern, R.L., Mannix, L.K., Adelman, J.U., Efficacy of topiramate in prophylactic treatment of migraines in patients refractory to preventive intervention : A retrospective chart review in a tertiary clinic (2000) Cephalalgia, 20 (389), p. 423
Wilson, M.-C., Efficacy of topiramate in the prophylactic treatment of intractable chronic migraine : A retrospective chart analysis (2000) Cephalalgia, 20 (87), p. 301
Zakrzewska, J.M., Chaudhry, Z., Nurmikko, T.J., Patton, D.W., Mullens, F.L., Lamotrigine in refractory trigeminal neuralgia (1997) Pain, 73, pp. 223-230
