Sinusitis With Polyposis Presenting as Refractory Trigeminal Neuralgia Treated With Acupuncture and Chinese Herbal Decoction

Abstract

Background: Trigeminal neuralgia is a common neuralgia condition. Most data available relate to primary trigeminal neuralgia, but little has been published about secondary trigeminal neuralgia treated with Chinese medicine. Objective: To describe a case of secondary trigeminal neuralgia treated with acupuncture and Chinese herbal decoction. Design and Patient: Case report of an Australian woman who presented in August 2005 with severe symptoms of trigeminal neuralgia (diagnosed in 2002). She had undergone carbamazepine treatment for 3 years. She also presented with sinusitis with polyposis. Intervention: Acupuncture needles were applied with manual methods to the affected ophthalmic branch and maxillary branch of the trigeminal nerve. Acupoints selected were ST 7 (Xiaguan), SI 19 (Tinggong), Ex-HN5 (Taiyang), GB 14 (Yangbai) (all right side), and LI 4 (Hegu) (both sides). De Qi was elicited every 3 minutes in a 20-minute session. Acupuncture was performed once a week for 12 sessions. Also, an individually designed Chinese herbal decoction was used as a coordinated approach for the treatment of sinusitis with polyposis. Main Outcome Measures: Resolution of trigeminal neuralgia symptoms and improved symptoms of sinusitis. Results: The severe trigeminal neuralgia gradually disappeared within 7 days after the first session of acupuncture treatment. This result was maintained during a 12-session acupuncture treatment course as well as during an herbal treatment period. Most importantly, this result has been maintained for more than 3 years. The patient's sinusitis was also resolved. Conclusions: The combination of acupuncture and Chinese herbal decoction treatment led to a complete disappearance of symptoms of trigeminal neuralgia (after a 3-year course of carbamazepine, which became ineffective 2 months prior to acupuncture). This approach may offer a new treatment and supports the necessity for further research to evaluate Traditional Chinese Medicine in the treatment of trigeminal neuralgia and sinusitis.