More MS news articles for June 2001

Fosphenytoin Relieves Trigeminal Neuralgia Crisis

http://www.medscape.com/reuters/prof/2001/06/06.25/20010622clin016.html

WESTPORT, CT (Reuters Health) Jun 22 - Intravenous fosphenytoin can alleviate trigeminal neuralgia temporarily, allowing time to adjust oral medications or prepare for neurosurgical intervention, according to Dr. William P. Cheshire, Jr., from the Mayo Clinic in Jacksonville, Florida.

In the June issue of the Journal of Pain and Symptom Management, Dr. Cheshire reports on three patients with recurrent trigeminal neuralgia refractory to oral anticonvulsants. In a tertiary care neurology clinic, he treated each urgently with intravenous phenytoin sodium equivalents of fosphenytoin for an episode of extreme pain.

Pain returned in all cases despite treatment with carbamazepine, gabapentin and carbamazepine, or baclofen and carbamazepine. The patients eventually required suboccipital craniectomy or balloon compression.
Dr. Cheshire maintains that, compared with phenytoin treatment, fosphenytoin is safer, better tolerated and can be given at a faster infusion rate. "Fosphenytoin," he concludes, "would appear to be an attractive and reliable substitute for parenteral phenytoin as a rapid onset, short-team treatment in select patients with acute, severe trigeminal neuralgia crisis episodes."

J Pain Symptom Manage 2001;21:506-510.
 

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