Tratamiento acupuntural de la neuralgia del trigémino resistente a la farmacoterapia convencional. Estudio retrospectivo

Abstract

IntroductionAlthough pharmacotherapy has been shown to be effective in the treatment of trigeminal neuralgia (NT), there are patients who do not achieve a good response, or who have intolerable adverse effects. Neurosurgery, also effective, has contraindications, risks and recurrences. Although acupuncture has been associated with pain relief, this response needs to be more documented in patients with poor response to conventional pharmacotherapy. We set out to describe the clinical outcome of patients with trigeminal neuralgia with poor response to medications, treated with stimulation of acupuncture points, determining their effects on pain intensity. MethodsWe conducted a retrospective study reviewing clinical charts, in one centre, including patients diagnosed with trigeminal neuralgia with poor response to conventional pharmacotherapy, who were treated with laser and needle acupoint stimulation, 3 sessions weekly, 4 to 12 weeks. Pain intensity was the principal measurement. ResultsSeven patients, with 5 months or more with trigeminal neuralgia without response to conventional pharmacotherapy were analysed. Five were women. The mean age of the patient was 59.0 years (range 34–87 years). All tolerated the treatment well. Pain intensity decreased significantly (from a mean [SD] 9.8 [.4] at the beginning, to 2.3 [2.5] in session 10 (week 4), and to 1.3 [2,0] at week 12; p < .001). At week 4, in 5 patients, pain intensity had decreased by 50%, and 3 were without pain. ConclusionsPatients with trigeminal neuralgia and poor response to conventional pharmacotherapy, treated with stimulation of acupunctural points using needles and laser puncture, with individualized selection according to diagnosis by traditional Chinese medicine, had a satisfactory clinical outcome with good treatment tolerance and significant relief of pain intensity.