Patient Evaluation and Preparation

Abstract

At the first visit to the pain clinic, after taking a medical history and a thorough clinical examination, the type of pain was evaluated. Trigeminal neuralgia had been diagnosed according to White and Sweet criteria (13): paroxysmal pain, pain that may be triggered by a light touch to the face, pain that is confined to the distribution of the trigeminal nerve, and pain that is unilateral. Sixty-three patients were assessed for eligibility; 14 were found to be suffering from atypical facial pain and excluded. Forty-nine patients who had received oral carbamazepine up to 600 mg in divided doses every 24 hours as the first line treatment were assessed after 2 weeks. In case of failure to achieve improvement (a 50% reduction in pain score and a decrease in attack frequency by > 50%), carbamazepine was substituted with pregabalin 150-300 mg daily. After another 2 weeks, the patients were re-evaluated to assess their improvement. Sixteen patients who reported a reduction in their pain of more than 50% and a decrease of attack frequency by > 50% were excluded from the study. So, 33 patients were recruited and randomly allocated in each group.