Successful Treatment of Painful Trigeminal Neuropathy Caused by a Basilar Artery Aneurysm, Using Combined Analgesic and Kampo Therapy

Abstract

We present a case of painful trigeminal neuropathy that was successfully treated with hangebyakujutsutenmato (HBT) extract, a traditional Japanese medicine. A 76-year-old woman experienced severe left facial pain caused by a large basilar artery aneurysm compressing the brainstem. Administration of gabapentin (GPT) reduced facial pain slightly. However, attempts to increase the GPT dose aggravated dizziness and gait disorder. GPT combined with HBT relieved both facial pain and dizziness, enabling dose reduction of GPT. The classical text “Hiiron,” the original literature on HBT, recommends this medicine for headaches and/or dizziness secondary to gastrointestinal dysfunction caused by inappropriate treatment. Many different medicines can cause dizziness, and HBT may be useful for the treatment of this side effect.