Contributions
Abstract: EP1814
Type: ePoster
Abstract Category: Therapy - symptomatic - 33 Treatment of specific symptoms
Objective: To determine whether trigeminal neuralgia (TN) emerges or worsens with the use of dalfampridine in patients with multiple sclerosis (MS).
Introduction: Dalfampridine (4-aminopyridine) is a broad-spectrum, voltage-dependent potassium channel blocker which improves action potential conduction in demyelinated motor axons. Several studies showed that dalfampridine is effective in treating gait impairment in MS patients.
Methods: Thirty one clinically definite MS patients using dalfampridine for gait impairment participated in the study. The variables examined included age, gender, type of MS, and the existence of trigeminal neuralgia.
Results: Nineteen (61%) of the patients were women and twelve were men. 55% of the patients were diagnosed as secondary progressive, 29% relapsing remitting, and 16% primary progressive MS. Of the thirty one patients, five (%16) had trigeminal neuralgia. Two of these patients had preexisting TN signs, which worsened following the use of dalfampridine and became unbearable. Three patients began to suffer from TN signs after the administration of the treatment. Brain MRIs showed no structural pathologies, rather than demyelinative lesions of the brainstem. All patients were treated with gabapentine. Symptomatic treatment with gabapentine did not result in the reduction of the severity of the pain thus dalfampridine ceased in three patients. Discontinuation of dalfampridine controlled the pain well in two patients, but one patient continued to have severe pain.
Discussion: Evidence from this study suggests the use of dalfampridine may worsen preexisting TN or trigger de novo TN symptoms in MS patients.
Disclosure:
Sila Usar Incirli: nothing to disclose
Abstract: EP1814
Type: ePoster
Abstract Category: Therapy - symptomatic - 33 Treatment of specific symptoms
Objective: To determine whether trigeminal neuralgia (TN) emerges or worsens with the use of dalfampridine in patients with multiple sclerosis (MS).
Introduction: Dalfampridine (4-aminopyridine) is a broad-spectrum, voltage-dependent potassium channel blocker which improves action potential conduction in demyelinated motor axons. Several studies showed that dalfampridine is effective in treating gait impairment in MS patients.
Methods: Thirty one clinically definite MS patients using dalfampridine for gait impairment participated in the study. The variables examined included age, gender, type of MS, and the existence of trigeminal neuralgia.
Results: Nineteen (61%) of the patients were women and twelve were men. 55% of the patients were diagnosed as secondary progressive, 29% relapsing remitting, and 16% primary progressive MS. Of the thirty one patients, five (%16) had trigeminal neuralgia. Two of these patients had preexisting TN signs, which worsened following the use of dalfampridine and became unbearable. Three patients began to suffer from TN signs after the administration of the treatment. Brain MRIs showed no structural pathologies, rather than demyelinative lesions of the brainstem. All patients were treated with gabapentine. Symptomatic treatment with gabapentine did not result in the reduction of the severity of the pain thus dalfampridine ceased in three patients. Discontinuation of dalfampridine controlled the pain well in two patients, but one patient continued to have severe pain.
Discussion: Evidence from this study suggests the use of dalfampridine may worsen preexisting TN or trigger de novo TN symptoms in MS patients.
Disclosure:
Sila Usar Incirli: nothing to disclose