Background: The aim of this study is to evaluate the use
of carbamazepine as primary definitive diagnostic aid in
patients with classical/idiopathic and symptomatic/
pathological trigeminal neuralgia by analyzing the pain
relief. Advantages of using carbamazepine is its easy
availability, cost effective, non-invasive, no machine
needed, simple, no specialized team needed and is itself a
mode of treatment for trigeminal neuralgia as compared to
MRI and CT.
Methods: 100 patients with clinical characteristics
signifying trigeminal neuralgia were included in this study
in the age group of 50-65 years from both sexes who were
examined clinically and radiographically. Sensory input of
trigeminal nerve, gross motor input, diagnostic analgesic
blocking and 0.5cc of normal saline at test site is also used
to differentiate pain. All 100 patients were given tab.
carbamazepine 100 mg twice daily to analyze the pain
relief.
Results and Conclusion: Clinical signs and symptoms
were present in all 100 patients who were given tab.
carbamazepine. 76 patients without any known cause for
trigeminal neuralgia responded well so had pain relief and Other 24 patients did not responded and had pain existing
who on further evaluation were diagnosed with
symptomatic trigeminal neuralgia due to some other
irrelevant pathological causes. This suggests response to
treatment with tab. carbamazepine as pain relief can be
used as a universal primary definitive diagnostic aid in
patients with trigeminal neuralgia. Failure to obtain any
improvement with this treatment should bring the
diagnosis into question? Sometimes patient is not able to
afford costly investigations like MRI and CT, hence the
medical management can be started with tab.
carbamazepine to diagnose the condition. We recommend
MRI and CT as further secondary investigations to rule
out cause for symptomatic trigeminal neuralgia due to
some other irrelevant pathological causes.
Keywords: Carbamazepine; Definitive Diagnostic Aid;
MRI and CT; Trigeminal Neuralgia