Relief of glossopharyngeal neuralgia by ketamine-induced N-methyl-aspartate receptor blockade.

摘要: OBJECTIVE: We examined whether ketamine, which is a noncompetitive blocker of N-methyl-D-aspartate (NMDA) receptors, had the ability to relieve glossopharyngeal neuralgia. A tentative hypothesis that neuralgia involves hyperactivity in central nociceptive neurons and development this dependent on activation NMDA receptors. CLINICAL PRESENTATION: The pain syndrome 56-year-old woman lasted for approximately 7 years was localized posterior pharynx, tonsillar region, base tongue, with radiation left deep ear structures. Pain provoked by swallowing. INTERVENTION: It first determined double-blind experiment intravenous ketamine markedly reduced pain. optimal oral dose (60 mg administered six times/d) observed an open escalating trial. In N 1 trial, patient received double blindly either or placebo during 10 2-day periods. Ketamine caused marked relief, as shown statistically significant relief reduction intensity. swallowing also ketamine. associated some side effects; however, treatment well tolerated patient. CONCLUSION: This case report shows ketamine-induced receptor blockade significantly relieved Therefore, receptors may play role pathogenesis described.