The Effectiveness of Transcutaneous Electrical Nerve Stimulation Versus Carbamazepine in Trigeminal Neuralgia: A Randomized Controlled Trial

Abstract

Objectives To determine if the treatment of refractory trigeminal neuralgia (TN) with transcutaneous electrical nerve stimulation (TENS) could lead to improved pain control. Materials and Methods We enrolled 20 patients with refractory TN in a double blinded, randomized, placebo-controlled clinical trial. Patients received either TENS for group 1 (n=10) or carbamazepine (CBZ) for group 2 (n=10). The visual analog pain scale (VAS) and the barrow neurological institute (BNI) pain scale, the number and duration of pain episodes and daily analgesic intake were analyzed for each group at 1 month, 2 months, 3 months, 1 year, 3 years and 5 years. Results The TENS group achieved better pain control than the CBZ group (p<0.05). Pain-free patients accounted for 60% in the TENS group and 50% in the CBZ group 1 month after initiating treatment, 100% and 77.77% at 3 months, 100% and 62.5% at 1 year, 100% and 50% at 3 years, respectively. The TENS group remained pain free for 3 years. At the 5-year mark, all members of the TENS group and the CBZ group presented pain recurrence. Conclusion TENS group scored significantly lower in pain scales compared with the CBZ group. TENS group was pain free for a longer period of time compared with the CBZ group. Significant differences between both groups favored TENS therapy, however the small sample size remains an important limitation of this study.