三叉神経痛に対して牛車腎気丸および柴苓湯の併用が有効であった１例

抄録

A female patient in her 30s developed intractable trigeminal neuralgia on the left side of her face due to a metastatic tumor in the left middle cranial fossa. Despite being treated with carbamazepine, gabapentin, pregabalin, baclofen, tramadol, lidocaine, Neurotropin, and nerve block, the trigeminal neuralgia was not resolved. After a joint discussion between pharmacists and neurosurgeons, the patient was suspected of having trigeminal neuralgia with facial numbness due to a tumor. We, therefore, administered traditional the Japanese herbal medicine Goshajinkigan, a formulation approved for pain and numbness. An MRI revealed a tumor with edema around the left trigeminal nerve, and the traditional Japanese herbal medicine Saireito was also administered to reduce edema. Her neuralgia improved markedly after Goshajinkigan and Saireito administration, i.e., the pain was confined to a narrow area on her left lower eyelid, temple, and lower jaw. Furthermore, her breakthrough pain scale score decreased from numerical rating scale (NRS) 10 to NRS 3, and her continuous pain scale score decreased from NRS 10 to NRS 0. The findings from this case suggest that Goshajinkigan and Saireito may benefit patients with intractable trigeminal neuralgia.