Misoprostol in the treatment of trigeminal neuralgia associated with multiple sclerosis

Multiple sclerosis can be associated with trigeminal neuralgia which is often difficult to treat in this specific condition. We performed an open prospective trial on the efficacy and safety of the prostaglandin-E1-analogue misoprostol (600 μg per day) in the reduction of attack frequency and pain intensity in patients with refractory trigeminal neuralgia associated with multiple sclerosis. Eighteen patients completed the study period and 14 of them showed a reduction of more than 50 % in attack frequency and intensity beginning five days after treatment onset. There were only mild and transient drug related side effects in three patients. One patient stopped taking misoprostol after the study period because of severe menorrhagia. Our results suggest that misoprostol is effective and safe in the treatment of this specific type of refractory trigeminal neuralgia. Received: 11 September 2002, Received in revised form: 13 November 2002, Accepted: 21 November 2002 Correspondence to Stefan Evers, MD, Department of Neurology, University of Münster, Albert-Schweitzer-Str. 33, 48129 Münster, Germany, Fax: +49-251/8348181, E-Mail: everss@uni-muenster.de The DMKG study group (The members of the study group contributing to this work are listed in the appendix.)