Intravenous fosphenytoin therapy for rescue of acute trigeminal neuralgia crisis in patients awaiting neurosurgical procedures: A cross-sectional study
| Autor: | Shusaku Noro, Masanori Kyono, Yuki Amano, Kazuya Sako, Masahiro Okuma, Yoshinobu Seo, Hirohiko Nakamura, Kaori Honjo, Bunsho Asayama |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Phenytoin
Cross-sectional study medicine.medical_treatment Trigeminal neuralgia Interquartile range Rating scale Fosphenytoin Physiology (medical) Statistical significance medicine Humans Saline Aged Retrospective Studies business.industry General Medicine Trigeminal Neuralgia medicine.disease Cross-Sectional Studies Neurology Anesthesia Anticonvulsants Female Surgery Neurology (clinical) business medicine.drug |
| Zdroj: | Journal of Clinical Neuroscience. 94:59-64 |
| ISSN: | 0967-5868 |
| DOI: | 10.1016/j.jocn.2021.09.040 |
| Popis: | Few treatments exist for acute attacks of trigeminal neuralgia. Therefore, this study aimed to investigate the efficacy and safety of an intravenous fosphenytoin therapy protocol in a trigeminal neuralgia crisis. We conducted a single-center, retrospective, observational study of the records of 20 patients with trigeminal neuralgia who received intravenous fosphenytoin therapy (15 mg/mL in normal saline at 50 mg/min for 15 min, total 750 mg) during hospitalization between September 2015 and August 2020. Serum phenytoin concentration was measured 30 min post-infusion. Pain severity was evaluated using a numerical rating scale and was analyzed for statistical significance. The mean age of the patients was 67.5 years (female, 50.0%). The median numerical rating scale score (interquartile range) of pain severity was 2.35 (0-10), 0.65 (0-5), 0.15 (0-1), 2.00 (0-8), and 4.30 (0-10) at 15, 30, and 60 min, and 12 and 24 h, respectively (p .001); the numerical rating scale score was 10 before treatment. Reduction in pain 24 h following treatment was significant. The mean phenytoin concentration was 12.8 μg/mL 30 min post-treatment. While mild dizziness occurred in four patients, all could walk independently within 60 min. The mean age and weight of patients with mild dizziness were significantly higher and lower, respectively (p .001), than those of other patients. These results may provide physicians with new insights into the innovative therapeutic option of intravenous fosphenytoin and contribute to advancements in treating acute trigeminal neuralgia crisis. |
| Databáze: | OpenAIRE |
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