Effect of Acupuncture in Trigeminal Neuralgia

Abstract

ABSTRACT

Background:

Trigeminal neuralgia (TN) is an extremely painful and difficult condition to treat. Existing medical and surgical therapies are moderately effective in many cases, but for a considerable number of patients, these are less than satisfactory and are fraught with failure to respond, considerable side effects of the medications, complications of surgery, and postoperative relapses. Acupuncture has a long-standing reputation of being helpful in various pain syndromes and reportedly has been effective in TN.

Objective:

To describe the experience of using acupuncture in a series of patients with TN that did not respond to conventional therapies.

Design, Setting, and Patients:

A series of 17 consecutive patients who were referred through July 2007 with the diagnosis of TN to a solo practice of internal medicine and acupuncture in Kansas City, Missouri.

Intervention:

A series of 30-minute treatment sessions consisted of the following: Dispersion of LR 3, MH 6, TH 5, GB 34 with stimulation of LI 4 and ST 36 (2 Hz), and simultaneous stimulation (30 Hz) of the facial points including ST 2, ST 3, LI 20, SI 18, and SI 19. If the supraorbital branch was involved, BL 2 was included. A gold semi-permanent needle was inserted in the trigeminal point of the ipsilateral ear.

Main Outcome Measure:

Relief of pain following acupuncture.

Results:

Of the 17 patients, 2 did not have classic TN. Three patients did not return after the second treatment. These patients were excluded from this series. Of the remaining 12 patients with classic TN, 4 of 5 men and all 7 women responded with markedly decreased visual analog scale scores (VAS; from mean [SD], 8.75 [1.02] to 1.95 [2.84]; P < .001). Five patients (1 man and 4 women) stayed in complete remission, which has lasted 11–15 months following their last acupuncture treatment. These 5 patients stopped taking all medications for TN. The remainder of the patients have continued to receive acupuncture on an as-necessary basis (mean [SD], 31.65 [18.26] days) for the maintenance of pain relief and no resistance to therapy has developed, with the longest follow-up being 18 months. The patients who had a history of multiple operations and procedures also had a good response. No adverse effects were observed.

Conclusions:

Acupuncture produced beneficial effects in the majority of patients in this series. Acupuncture should be considered as a safe therapeutic option in patients with TN, especially before invasive intervention is done.