Nishie Hiroyuki, Sakuta Yuka, Nakatsuka Hideki
Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School Hospital, 577, Matsushima, Kurashiki, Okayama, 701-0192, Japan.
JA Clin Rep. 2023 Feb 7;9(1):5. doi: 10.1186/s40981-023-00596-x.
Glossopharyngeal neuralgia is a condition that causes severe pain in the throat during swallowing. Although carbamazepine is a viable option for treating glossopharyngeal neuralgia, there are minimal data regarding the effect of alternative agents to treat it. We report on glossopharyngeal neuralgia, which is successfully controlled by levetiracetam.
A woman in her 70s checked into our hospital with a chief complaint of neck pain lasting 5 years. She had a history of carbamazepine-induced interstitial pneumonia. As a result, we prescribed oral levetiracetam 1000 mg daily in addition to mirogabalin, which was previously prescribed. This effectively reduced the numerical rating scale from 9 to 1 with no adverse effects. Finally, she underwent microvascular decompression, and her symptoms were resolved.
Levetiracetam may be an option for patients with glossopharyngeal neuralgia who cannot receive carbamazepine. However, levetiracetam is for off-label use according to the Japanese medical system.
舌咽神经痛是一种在吞咽时会导致喉咙剧痛的病症。尽管卡马西平是治疗舌咽神经痛的一种可行选择，但关于其他替代药物治疗该病效果的数据极少。我们报告了一例由左乙拉西坦成功控制病情的舌咽神经痛病例。
一名70多岁的女性因颈部疼痛持续5年为主诉入住我院。她有卡马西平诱发间质性肺炎的病史。因此，除了之前开具的米罗加巴林外，我们还为她每日开具1000毫克口服左乙拉西坦。这有效地将数字评分量表的评分从9分降至1分，且无不良反应。最后，她接受了微血管减压手术，症状得以缓解。
对于无法使用卡马西平的舌咽神经痛患者，左乙拉西坦可能是一种选择。然而，根据日本医疗体系，左乙拉西坦属于超说明书用药。
