Lacosamide as an alternative in the treatment of post-surgery neuropathic pain in an allergic patient
*Correspondencia: Dra. María Estefanía Monge Márquez. Departamento de Neurofisiología Clínica. Servicio de Neurocirugía. Hospital Universitario Virgen del Rocío. Instituto de Biomedicina de Sevilla. Cardenal Ilundain, s/n.
E-41013 Sevilla.
E-mail: estefania@monge.com.es
INTRODUCTION Neuropathic pain is a condition that is still not well understood, although it affects a significantly high percentage of the population. The main problem lies in the fact that it can become a fairly disabling pathology. The most frequent treatment is based essentially on two drugs: gabapentin and pregabalin. Other pharmaceuticals, such as antidepressants, opioids or N-methyl-D-aspartate receptor antagonists can also be employed in combination with the primary drugs. All the same, treatment remains unsatisfactory. Furthermore, it must be borne in mind that there may be patients who are allergic to the two main drugs.
CASE REPORT We report the case of a 36-year-old female with neuropathic pain secondary to surgery to correct a neurinoma in the brachial plexus, who could not be treated with gabapentin or pregabalin because of a personal history of allergy to these substances. Treatment with another drug (lacosamide), however, was very effective and displayed a very good response.
CONCLUSIONS Lacosamide is a third-generation antiepileptic drug that has been proven to be effective, safe and with few side effects. It has been considered a good therapeutic option for the treatment of neuropathic pain in patients who are allergic to pregabalin.
Caso clínico Mujer de 36 años, afecta de dolor neuropático secundario a una cirugía de neurinoma del plexo braquial, cuyo tratamiento con gabapentina o pregabalina no era posible por tener antecedentes personales de alergia. Sin embargo, el tratamiento con otro fármaco (lacosamida) resultó muy efectivo, al presentar muy buena respuesta.
Conclusión La lacosamida es un fármaco antiepiléptico de tercera generación, eficaz, seguro y con pocos efectos secundarios. Se ha considerado una buena opción terapéutica para el tratamiento del dolor neuropático en pacientes alérgicos a la pregabalina.
