Michelle Cristina Ichida1, Mariana Zemuner1, Jorge Hosomi2,3, Hong Jin Pai2,3, Manoel Jacobsen Teixeira1,3,4, José Tadeu Tesseroli de Siqueira5,6, Silvia R D T de Siqueira7,8,9. 1. Neurology Department, Medical School, University of São Paulo, São Paulo, 05403-010, Brazil. 2. Group of Acupuncture, Interdisciplinary Pain Group of the Neurology Division, Clinical Hospital, Medical School, University of São Paulo, São Paulo, 05403-010, Brazil. 3. Interdisciplinary Pain Center of Hospital das Clinicas, Neurology Department, Medical School, University of São Paulo, São Paulo, 05403-010, Brazil. 4. Neurosurgery Division, Psychiatry Institute, Clinical Hospital, Medical School, University of Sao Paulo, São Paulo, 05403-010, Brazil. 5. Orofacial Pain Team, Dentistry Division, Clinical Hospital, Medical School, University of São Paulo, São Paulo, 05403-010, Brazil. 6. Group of Oral Medicine and Neuroscience of the Dentistry Division, Psychiatry Institute, Clinical Hospital, Medical School, University of Sao Paulo, São Paulo, 05403-010, Brazil. 7. Neurology Department, Medical School, University of São Paulo, São Paulo, 05403-010, Brazil. silviadowgan@hotmail.com. 8. Group of Oral Medicine and Neuroscience of the Dentistry Division, Psychiatry Institute, Clinical Hospital, Medical School, University of Sao Paulo, São Paulo, 05403-010, Brazil. silviadowgan@hotmail.com. 9. School of Arts, Science and Humanities, University of São Paulo, São Paulo, 05403-010, Brazil. silviadowgan@hotmail.com.
Abstract
OBJECTIVE: To evaluate the treatment effect of acupuncture on patients with idiopathic trigeminal neuralgia (ITN) by case-control longitudinal blinded study. METHODS:Sixty ITN patients and 30 healthy subjects were included. The ITN patients were randomly assigned to acupuncture group (15 cases), sham-acupuncture group (15 cases) and carbamazepine group (30 cases), respectively. Clinical orofacial evaluation (including pain intensity and medication doses), research diagnostic criteria for temporomandibular disorders (RDC/TMD) and Helkimo indexes (for functional evaluation of the masticatory system), and quantitative sensory testing for sensory thresholds (gustative, olfactory, cold, warm, touch, vibration and superficial and deep pain) were evaluated before treatment, immediately after treatment, and 6 months after treatment. RESULTS: The mean pain intensity by the Visual Analogue Scale only decreased in the acupuncture group at the last evaluation (P=0.012). Patients in the sham-acupuncture group had an increase in carbamazepine doses according to the prescriptions (P<0.01). There was a reduction in secondary myofascial pain and mandibular limitations at the acupuncture and sham-acupuncture groups, however only the acupuncture group kept the changes after 6 months (P<0.01, P=0.023). There was a decrease in mechanical thresholds in the acupuncture group (tactile, P<0.01; vibration, P=0.027) and an increase in deep pain thresholds in both acupuncture and sham-acupuncture groups (P=0.013). CONCLUSIONS:Acupuncture can be an option in the treatment of ITN due to its analgesic effect in both ITN and secondary myofascial pain associated with it.
RCT Entities:
OBJECTIVE: To evaluate the treatment effect of acupuncture on patients with idiopathic trigeminal neuralgia (ITN) by case-control longitudinal blinded study. METHODS: Sixty ITN patients and 30 healthy subjects were included. The ITN patients were randomly assigned to acupuncture group (15 cases), sham-acupuncture group (15 cases) and carbamazepine group (30 cases), respectively. Clinical orofacial evaluation (including pain intensity and medication doses), research diagnostic criteria for temporomandibular disorders (RDC/TMD) and Helkimo indexes (for functional evaluation of the masticatory system), and quantitative sensory testing for sensory thresholds (gustative, olfactory, cold, warm, touch, vibration and superficial and deep pain) were evaluated before treatment, immediately after treatment, and 6 months after treatment. RESULTS: The mean pain intensity by the Visual Analogue Scale only decreased in the acupuncture group at the last evaluation (P=0.012). Patients in the sham-acupuncture group had an increase in carbamazepine doses according to the prescriptions (P<0.01). There was a reduction in secondary myofascial pain and mandibular limitations at the acupuncture and sham-acupuncture groups, however only the acupuncture group kept the changes after 6 months (P<0.01, P=0.023). There was a decrease in mechanical thresholds in the acupuncture group (tactile, P<0.01; vibration, P=0.027) and an increase in deep pain thresholds in both acupuncture and sham-acupuncture groups (P=0.013). CONCLUSIONS: Acupuncture can be an option in the treatment of ITN due to its analgesic effect in both ITN and secondary myofascial pain associated with it.