2017 Volume 24 Issue 4 Pages 336-340
A 76-year-old man presented at our institution, with a 6-year history of left trigeminal neuralgia, originally treated with carbamazepine. Although the drug had to be discontinued due to hypersensitive reaction, the patient's neuralgia resolved following administration of prednisolone. Recurrence of the trigeminal neuralgia occurred 2 years ago, and this was relieved by pregabalin. The patient presented this year with pain during conversation, swallowing, and chewing. However, pregabalin no longer relieved the patient's pain. On the basis of his symptomology, the patient was diagnosed with glossopharyngeal neuralgia. A brain magnetic resonance imaging scan showed that there was no contact of the blood vessels with either the trigeminal or the glossopharyngeal nerves. The patient was found to be suffering from a severe eating disorder, and carbamazepine was prescribed to be taken as needed. A few days later, there was improvement in the patient's pain, but systemic drug eruption had recurred. Despite the discontinuation of the carbamazepine, the patient's neuralgia disappeared following prednisolone pulse therapy, and it did not recur after the prednisolone therapy was terminated. We conclude that prednisolone pulse therapy represents a possible treatment modality in cases of refractory trigeminal or glossopharyngeal neuralgia.
