Lacosamide for refractory trigeminal neuralgia and other facial pain—Case report

To demonstrate effect of lacosamide monotherapy in three patients with refractory facial pain of various etiologies.Many medications used to treat trigeminal neuralgia and other facial pain, including first- and second-generation anticonvulsants, are often ineffective or have intolerable side-effects. Lacosamide, a third-generation anticonvulsant, has fewer side-effects and is a potential treatment of facial pain.Retrospective review of three patients treated with lacosamide for facial pain.The etiologies of the facial pain were idiopathic trigeminal neuralgia (TN), TN secondary to a mass, and persistent idiopathic facial pain. Treatment with lacosamide led to significant improvement in pain in all three patients. Lacosamide was well tolerated without any reported side-effects.Lacosamide effectively relieved idiopathic and secondary facial pain in three previously refractory patients. It may be effective for the treatment of refractory facial pain and could be considered as an alternative treatment for patients who do not respond or tolerate standard treatments for facial pain.