PA Medical News about Carbamazepine Trigeminal Neuralgia Neurovascular Compression MR cisternography

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Relationship Between the Curative Effects of Carbamazepine Administration and the Neurovascular Compression Volume of the Trigeminal Nerve Measured Using Magnetic Resonance Cisternography
The Clinical Journal of Pain, 10/20/09

Tanaka T et al. – Three–dimensional MR cisternography is very useful for detecting the site of neurovascular compression (NVC) in patients with trigeminal neuralgia. NVC measured by this technique may indicate the prognosis after initial treatment. The present results suggest that the evaluation of NVC volume by MR cisternography would be useful in choosing the initial treatment for patients with trigeminal neuralgia.

Methods

MR cisternography was performed on 214 patients with clinical signs and symptoms that suggested trigeminal neuralgia retrospectively.
The extent of their pain was evaluated using visual analog scales.
Only carbamazepine was administered as the initial treatment.
For the patients with NVC detectable on MR cisternography, the relationship between the extent or nature of the pain and the neurovascular volume was analyzed.
In addition, the correlation between the efficacy of carbamazepine treatment and the NVC volume was evaluated retrospectively.

Results

Of the 214 patients evaluated, 144 were deemed to have NVC.
In these 144 patients, a significant difference was found between the NVC volume and the curative effects of 100 mg/d carbamazepine.
However, no significant correlation was found between the extents of pain by visual analog score or between the daily dosage of carbamazepine and the NVC volume measured by MR cisternography.