The Effects of Local Streptomycin/lidocaine Injections on Treatment of Carbamazepine Resistant Trigeminal Neuralgia

Background and purpose: Trigeminal neuralgia is the most common type of facial neuralgia. The pain would easily affect the quality of life according to its acute and severe nature. Treatment modalities include pharmacotherapy, microvascular decompression, and lesioning peripheral procedures targeting the trigeminal ganglion. These methods either have side effects or are partially invasive; therefore a minimally invasive method without the common side effects of medical interventions is more desired. The aim of this study was to investigate the effects of streptomycin/lidocaine injection on patients with carbamazepine-resistant trigeminal neuralgia. In this retrospective case series, 40 subjects diagnosed with trigeminal neuralgia, who did not respond to carbamazepine, were investigated. The patients received five injections of streptomycin/lidocaine to the trigger zone with one-week intervals. Pain severity was recorded at one week, one month, and six months after the last injection. The severity of pain significantly reduced in all follow-up appointments compared to the baseline (P< 0.001). Pain reduction was significantly higher in patients with a history of the disease for less than five years. Streptomycin/lidocaine injection seems to be an easy, effective, and a safe method for pain relief in patients with trigeminal neuralgia. Nevertheless, further controlled studies are needed to approve this method as a routine procedure.