Neuromodulators for Atypical Facial Pain and Neuralgias: A Systematic Review and Meta-Analysis.
Adult
Amitriptyline
/ therapeutic use
Botulinum Toxins, Type A
/ therapeutic use
Carbamazepine
/ therapeutic use
Facial Nerve
Facial Pain
/ drug therapy
Female
Humans
Male
Middle Aged
Neuralgia
/ drug therapy
Neurotransmitter Agents
/ therapeutic use
Observational Studies as Topic
Odds Ratio
Pain Management
/ methods
Pain Measurement
Randomized Controlled Trials as Topic
Treatment Outcome
Trigeminal Neuralgia
/ drug therapy
Neuromodulators
amitriptyline
botulinum toxin
carbamazepine
facial pain
trigeminal neuralgia
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
31
08
2020
received:
15
05
2020
accepted:
18
09
2020
pubmed:
11
10
2020
medline:
19
5
2021
entrez:
10
10
2020
Statut:
ppublish
Résumé
To evaluate the effectiveness of neuromodulating agents for the management of atypical facial pain and primary facial neuralgias. We searched MEDLINE, Embase, CINAHL, and ClinicalTrials.gov databases for original research articles that examine the effectiveness and adverse reactions of pharmacologic therapy for the treatment of trigeminal neuralgia and atypical facial pain. Studies that included surgical interventions for atypical facial pain or facial pain secondary to other causes were excluded. Meta-analysis was conducted for reductions in symptom scores and adverse effects. Of 3,409 articles screened, 73 full-text articles were included, consisting of 45 observational studies and 29 randomized controlled trials. Twenty-four different pharmacological agents were assessed; carbamazepine was the most frequently studied while botulinum toxin A demonstrated the highest consistency in reduction of symptom scores. Pooled estimate of three randomized controlled trials revealed that patients with trigeminal neuralgia who received botulinum toxin A had higher odds (odds ratio 7.46; 95% CI 3.53-15.78) of achieving a ≥50% reduction in visual analogue scale scores compared to controls. Pooled estimate of 15 observational studies showed that three-fourths of patients with trigeminal neuralgia who received carbamazepine experienced clinically significant pain reduction (prevalence proportion 0.75; 95% CI 0.66-0.83). Patients receiving botulinum toxin A for trigeminal neuralgia had higher odds of achieving ≥50% reduction in pain scores. A significant proportion of patients with trigeminal neuralgia experienced positive response to carbamazepine. There was moderate evidence for amitriptyline in patients with atypical facial pain. Standardization of outcome reporting would facilitate future quantitative comparisons of therapeutic effectiveness. Laryngoscope, 131:1235-1253, 2021.
Substances chimiques
Neurotransmitter Agents
0
Amitriptyline
1806D8D52K
Carbamazepine
33CM23913M
Botulinum Toxins, Type A
EC 3.4.24.69
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1235-1253Informations de copyright
© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).
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