Therapeutic and Analgesic Efficacy of Laser in Conjunction With Pharmaceutical Therapy for Trigeminal Neuralgia

Hooman Ebrahimi; Shamsolmoulouk Najafi; Mina Khayamzadeh; Amirabbas zahedi; Atossa Mahdavi

Therapeutic and Analgesic Efficacy of Laser in Conjunction With Pharmaceutical Therapy for Trigeminal Neuralgia

Hooman Ebrahimi, Shamsolmoulouk Najafi, Mina Khayamzadeh, Amirabbas zahedi, Atossa Mahdavi

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Abstract

Introduction: Trigeminal neuralgia (TN) is the most common neuralgia in the head and neck region and a common cause of orofacial pain. It is routinely treated with carbamazepine. Laser, acupuncture and radiofrequency are among other treatment modalities for this condition. This study sought to assess the efficacy of laser therapy in conjunction with carbamazepine for treatment of TN.
Methods: A total of 30 patients who met the inclusion criteria were divided into 2 groups of cases and controls (n = 15) by double blind randomized controlled clinical trial. All patients received 100 mg carbamazepine at baseline and another 100 mg after 2 days for pain control. In the case group, low level laser therapy (LLLT) was also performed in addition to pharmaceutical therapy. Sham laser was used in the control group instead of LLLT. Treatment was continued for 9 sessions (3 days a week). The intensity of pain was measured and compared in the 2 groups using visual analog scale (VAS) in 3 period. The qualitative variables among the groups were compared using the repeated measures analysis of variance (ANOVA).
Results: The severity of pain was lower at the end of treatment in the case compared to the control group so this difference was statistically significant (P = 0.003). The severity of pain decreased in both groups over time. Significant difference was noted in this regard between the 2 groups either (P = 0.003). At the end of treatment pain intensity dropped in the intervention group from 6/8 to 1/2 and control group from 6/6 to 2/7.
Conclusion: Laser therapy did add to the value of pharmaceutical therapy for treatment of TN. Both groups experienced significant improvement over time. So it is better to used laser complementary therapy to reduce side effects and the medicine dosage.

Keywords

Trigeminal neuralgia; Carbamazepine; Laser.

References

Bagheri SC, Farhidvash F, Perciaccante VJ. Diagnosis and treatment of patients with trigeminal neuralgia. J Am Dent Assoc. 2004;135(12):1713-7.

Aguggia M. Typical facial neuralgias. Neurol Sci. 2005;26 Suppl 2:s68-70.

De Leeuw R. Orofacial pain. Chicago: Quintessence. 2008.

Krafft RM. Trigeminal neuralgia. Am Fam Physician. 2008;77(9):1291-6.

Fauci AS. Harrison's principles of internal medicine: McGraw-Hill, Medical Publishing Division; 2008.

Matwychuk MJ. Diagnostic challenges of neuropathic tooth pain. J Can Dent Assoc. 2004;70(8):542-6.

Peterson LJ, Ellis E, Hupp JR, Tucker MR. Contemporary oral and maxillofacial surgery: Mosby St. Louis, MO; 2003.

Levin LG, Law AS, Holland G, Abbott PV, Roda RS. Identify and define all diagnostic terms for pulpal health and disease states. J Endod. 2009;35(12):1645-57.

Chamani G, Zarei MR, Mehrabani M, Taghiabadi Y. Evaluation of Effects of Zingiber officinale on Salivation in Rats. Acta Med Iran. 2011;49(6):336.

Neville B, Damm D, Allen C. Bouquot. Epithelial Pathology Oral and Maxillofacial Pathology 3rd ed Reed Elsevier India Private Limited Noida. 2009:345.

Onwuekwe I, Onodugo O, Ezeala-Adikaibe B, Aguwa E, Ejim E, Ndukuba K, et al. Pattern and presentation of epilepsy in Nigerian Africans: a study of trends in the southeast. Trans R Soc Trop Med Hyg. 2009;103(8):785-9.

Society HCSotIH. The international classification of headache disorders. Cephalalgia: an international journal of headache. 2004;24:9.

Frost D, Hersh E, Levin L. Fonseca oral and maxillofacial surgery. PA Saunders, Philadelphia. 2000.

M.Lisa, E.Cassin, P.Theresa, Springhouse C. Professional's handbook of drug therapy for pain. Springhouse, PA: Springhouse; 2001.

Weiner RS. Pain management: a practical guide for clinicians: CRC press; 2001.

Lewis PJ, Pollina Jr J. Neurosurgery Views. Neurosurgery. 2005;2(1).

Antipa C, Moldoveanu V, Rusca N, Bruckner II, Podoleanu AG, Stanciulescu V, editors. Low-energy laser treatment of rheumatic diseases: a long-term study. Photonics West'95; 1995: International Society for Optics and Photonics.

Sweetman SC. Martindale: the complete drug reference: Pharmaceutical press; 2009.

Brondon P, Stadler I, Lanzafame RJ. Melanin density affects photobiomodulation outcomes in cell culture. Photomed Laser Surg. 2007;25(3):144-9.

Antipa C, Pascu M-L, Pascu R, Ionescu E, editors. Objective methods in evaluating low-level laser therapy results. Laser Florence 2000: A Window on the Laser Medicine World; 2000: International Society for Optics and Photonics.

Ohno T. [Pain suppressive effect of low power laser irradiation. A quantitative analysis of substance P in the rat spinal dorsal root ganglion]. Nihon Ika Daigaku Zasshi. 1997;64(5):395-400.

اسلامی.فارسانی ر, آشتیانی.عراقی ب, کامروا ک, رضوان ف. لیزرتراپی ، مبانی، اصول و کاربرد لیزر کم توان چاپ اول ، زیر نظر دکتر محمد فرهادی، تهران: بشری; 1384.

Ceylan Y, Hizmetli S, Siliğ Y. The effects of infrared laser and medical treatments on pain and serotonin degradation products in patients with myofascial pain syndrome. A controlled trial. Rheumatol Int. 2004;24(5):260-3.

Öz S, Gökçen-Röhlig B, Saruhanoglu A, Tuncer EB. Management of myofascial pain: low-level laser therapy versus occlusal splints. J Craniofac Surg. 2010;21(6):1722-8.

Graciele CT, Carrasco GLD, Zanello GDM, Oliveira MM. Evaluation of low intensity laser therapy in myofascial pain syndrome. CRANIO®. 2014.

Dundar U, Evcik D, Samli F, Pusak H, Kavuncu V. The effect of gallium arsenide aluminum laser therapy in the management of cervical myofascial pain syndrome: a double blind, placebo-controlled study. Clin Rheumatol. 2007;26(6):930-4.

Altan L, Bingöl U, Aykaç M, Yurtkuran M. Investigation of the effect of GaAs laser therapy on cervical myofascial pain syndrome. Rheumatol Int. 2005;25(1):23-7.

Hansen HJ, Thorøe U. Low power laser biostimulation of chronic oro-facial pain. A double-blind placebo controlled cross-over study in 40 patients. Pain. 1990;43(2):169-79.

Fulop AM, Dhimmer S, Deluca JR, Johanson DD, Lenz RV, Patel KB, et al. A meta-analysis of the efficacy of laser phototherapy on pain relief. The Clinical journal of pain. 2010;26(8):729-36.

اقبالی ف. کاربرد لیزرهای کم توان در دندانپزشکی.چاپ اول ، ویراستار علمی دکتر رضا فکر آزاد، تهران: شایان نمودار; 1388.

Shirani AM, Gutknecht N, Taghizadeh M, Mir M. Low-level laser therapy and myofacial pain dysfunction syndrome: a randomized controlled clinical trial. Lasers Med Sci. 2009;24(5):715-20.

Hakgüder A, Birtane M, Gürcan S, Kokino S, Nesrin Turan F. Efficacy of low level laser therapy in myofascial pain syndrome: an algometric and thermographic evaluation. Lasers Surg Med. 2003;33(5):339-43.

Walker J. Relief from chronic pain by low power laser irradiation. Neurosci Lett. 1983;43(2-3):339-44.

Yang H-W, Huang Y-F. Treatment of persistent idiopathic facial pain (PIFP) with a low-level energy diode laser. Photomed Laser Surg. 2011;29(10):707-10.

Ilbuldu E, Cakmak A, Disci R, Aydin R. Comparison of laser, dry needling, and placebo laser treatments in myofascial pain syndrome. Photomedicine and Laser Therapy. 2004;22(4):306-11.

PINHEIRO AL, CAVALCANTI ET, PINHEIRO TI, ALVES MJ, MIRANDA ER, DE QUEVEDO AS, et al. Low-level laser therapy is an important tool to treat disorders of the maxillofacial region. J Clin Laser Med Surg. 1998;16(4):223-6.

Pinheiro AL, CavalcantI ET, Pinheiro TI, Alves MJ, Manzi CT. Low-level laser therapy in the management of disorders of the maxillofacial region. J Clin Laser Med Surg. 1997;15(4):181-3.

Gam AN, Thorsen H, Lønnberg F. The effect of low-level laser therapy on musculoskeletal pain: a meta-analysis. Pain. 1993;52(1):63-6.

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