Palliative Care Medicine Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Science, Tabriz, Iran.
J Med Case Rep. 2022 May 8;16(1):183. doi: 10.1186/s13256-022-03393-9.
Despite some advances, treatment of trigeminal neuralgia remains a significant challenge. This study determines the efficacy and safety of autologous conditioned serum (Orthokine) injection into the foramen oval to treat refractory trigeminal neuralgia.
This is a consecutive case series from the Pain and Palliative Care Department of Imam Reza University Hospital, Tabriz, Iran. Eleven Iranian patients, eligible according to the inclusion and exclusion criteria, aged 45.64 ± 11.58 years (Four male and seven female, all Iranian) with established classical trigeminal neuralgia were injected with Orthokine (2 mL per injection) once a week for three consecutive weeks (total of four injections). Numeric rating scale scores for facial pain intensity and also carbamazepine daily dose were confirmed at pretreatment (T0) and at week 1 (T1), week 2 (T2), week 3 (T3), week 4 (T4), and month 2 (T5) posttreatment. Pain intensity was significantly reduced in the first 3 weeks of follow-up in comparison with baseline (T0 to T3) (8.18 ± 1.99 to 2.82 ± 2.13, p < 0.001), an effect that was retained at week 4 (T4) and month 2 (T5) follow-ups (2.82 ± 2.13 to 3.36 ± 2.69, p = 0.886). Carbamazepine consumption was significantly reduced in the first 3 weeks of follow-up in comparison with baseline (T0 to T3) (636.36 ± 307.48 to 200.00 ± 296.64, p = 0.003), an effect that was retained at week 4 and month 2 follow-ups (200.00 ± 296.64 to 200.00 ± 282.84, p = 0.802). There were no serious adverse events in participants.
Orthokine injection led to consistent pain relief and reduced carbamazepine dosage in patients with trigeminal neuralgia, with acceptable safety.
尽管取得了一些进展，但三叉神经痛的治疗仍然是一个重大挑战。本研究旨在确定自体条件血清（Orthokine）注射卵圆孔治疗难治性三叉神经痛的疗效和安全性。
这是伊朗大不里士礼萨大学医院疼痛和姑息治疗科的一项连续病例系列研究。11 名符合纳入和排除标准的伊朗患者（年龄 45.64 ± 11.58 岁[4 名男性和 7 名女性，均为伊朗人]，确诊为典型三叉神经痛）接受了 Orthokine（每次注射 2 毫升）治疗，每周一次，连续 3 周（共 4 次注射）。在治疗前（T0）和第 1 周（T1）、第 2 周（T2）、第 3 周（T3）、第 4 周（T4）和治疗后第 2 个月（T5），使用数字评分量表评估面部疼痛强度和卡马西平的日剂量。与基线相比（T0 至 T3），在随访的前 3 周内，疼痛强度显著降低（8.18 ± 1.99 至 2.82 ± 2.13，p<0.001），在第 4 周（T4）和第 2 个月（T5）随访时仍保持这种效果（2.82 ± 2.13 至 3.36 ± 2.69，p=0.886）。与基线相比（T0 至 T3），在随访的前 3 周内，卡马西平的消耗量显著减少（636.36 ± 307.48 至 200.00 ± 296.64，p=0.003），在第 4 周和第 2 个月的随访时仍保持这种效果（200.00 ± 296.64 至 200.00 ± 282.84，p=0.802）。参与者没有出现严重的不良事件。
Orthokine 注射可使三叉神经痛患者的疼痛持续缓解，并减少卡马西平的剂量，具有可接受的安全性。
