==GABAPENTIN AND HEADACHE== [Entrez medline Query] Reg Anesth 1997 Sep-Oct;22(5):473-8 Experience with gabapentin for neuropathic pain in the head and neck: report of ten cases. Sist TC, Filadora VA 2nd, Miner M, Lema M Department of Anesthesiology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. BACKGROUND AND OBJECTIVES: Gabapentin is an oral antiepileptic agent with an unknown mechanism of action. Recent case reports have suggested that gabapentin may be effective in the treatment of a variety of neuropathic pain states. This report presents baseline and follow-up data on ten patients who were treated with gabapentin when other pharmacologic interventions failed to relieve their neuropathic pain. METHODS: Ten patients referred for treatment of unrelieved neuropathic pain in the head and neck region were included in this study. Baseline and follow-up information included measures of pain intensity and pain quality. All of the patients were started on 300 mg gabapentin three times per day, though daily doses of up to 2400 mg were required for pain relief. RESULTS: Eight of the ten patients had no neuropathic pain on follow-up, whereas the remaining 2 patients reported only partial relief at follow-up. None of the patients complained of side effects. Gabapentin was effective in alleviating steady burning pain as well as lancinating pain and allodynia. CONCLUSIONS: The results suggest that gabapentin may be effective in the management of some cases of neuropathic pain in the head and neck. However, controlled, double-blind longitudinal studies are needed to evaluate this possibility. ------------------------------------------------------------------------ Clin J Pain 1997 Sep;13(3):251-5 The effect of gabapentin on neuropathic pain. Rosenberg JM, Harrell C, Ristic H, Werner RA, de Rosayro AM Department of Anesthesiology, University of Michigan Health System, Ann Arbor, USA. OBJECTIVE: To evaluate the effects of gabapentin on pain scores and opiate use. DESIGN: Retrospective review of patients charts who received gabapentin for at least 30 days. Data were collected concerning patients' diagnosis, current drug use, concurrent drug use, gabapentin dose, pain scores, and patient-reported side effects. Patients were divided into three groups based on their pain diagnosis; low back, neuropathic, and myofascial pain. The neuropathic group was subdivided into postherpetic neuralgia, diabetic neuropathy, sympathetically maintained pain, and phantom pain. SETTING: Two tertiary referral teaching hospitals in southeastern Michigan. RESULTS: A total of 122 charts were reviewed and included in this study. A significant decrease in pain scores with gabapentin was seen in the neuropathic pain group (paired t-test, p < .0001) but not in the low back pain group. Of the neuropathic pain group, patients with postherpetic neuralgia had the greatest decrease in pain scores. Ten patients showed a > 75% decrease in pain scores, of these: nine had a direct nerve injury, and one had postherpetic neuralgia. Opiate use was unchanged in all groups. Patients who were taking opiates had significantly less benefit with gabapentin use in terms of pain score. Patient-reported side effects were similar to those reported in a nonchronic pain population. CONCLUSION: Gabapentin may be a useful adjunct for treating neuropathic pain with a minimum of side effects. Particular advantage may be gained with the use of this drug for postherpetic neuralgia and direct peripheral nerve injuries. ------------------------------------------------------------------------ South Med J 1998 Aug;91(8):739-44 Gabapentin for treatment of pain and tremor: a large case series. Merren MD Neurology Clinic of San Antonio, TX 78229, USA. BACKGROUND: Several anticonvulsant agents, including carbamazepine, phenytoin, and valproate, are effective in some patients for the treatment of pain and tremor. This study reports on a trial of the newly introduced anticonvulsant, gabapentin, for pain and tremor control. METHODS: A large case series of patients with centrally mediated pain, peripherally mediated pain, migraine, and tremor were treated in an open-label study with gabapentin (maximum of 2,700 mg/day). RESULTS: Thirty-nine patients (65%) had moderate-to-excellent improvement in symptoms, with the best responses occurring in patients with peripherally mediated neuropathic pain. The other conditions treated that showed some improvement were benign essential/familial tremor, restless legs syndrome, centrally mediated pain, and periodic nighttime leg movements. CONCLUSIONS: Gabapentin offers an effective, safe alternative therapy or co-therapy for the listed painful conditions and tremor; it does not affect the metabolism of other medications and is well tolerated. ------------------------------------------------------------------------ Pain 1998 Feb;74(2-3):341-3 Gabapentin induced polyneuropathy. Gould HJ Department of Neurology, LSU Medical Center, New Orleans, LA 70112, USA. Gabapentin is an effective option for the treatment of neuropathic pain syndromes because of its efficacy and favorable side-effect profile. A case is presented of a 58 year old man who developed a painful polyneuropathy while being treated with gabapentin.