Fosphenytoin: An intravenous option for the management of acute trigeminal neuralgia crisis

William P. Cheshire

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Timely management of trigeminal neuralgia presenting with severe, sustained, crescendo pain can be difficult with oral medications. More rapid pain control often can be achieved using intravenous phenytoin. Fosphenytoin is a phosphate ester prodrug of phenytoin that is significantly better tolerated parenterally than phenytoin in the treatment of epilepsy. Three patients with trigeminal neuralgia refractory to oral medications and presenting with crisis pain were treated urgently with intravenous fosphenytoin. In each case complete relief of pain was achieved for a duration of two days, affording a window of opportunity to modify oral pharmacotherapeutic strategies or to control pain in preparation for invasive neurosurgical intervention.

Original languageEnglish (US)
Pages (from-to)506-510
Number of pages5
JournalJournal of pain and symptom management
Issue number6
StatePublished - 2001


  • Analgesia
  • Facial pain
  • Fosphenytoin
  • Infusions
  • Intravenous
  • Trigeminal neuralgia

ASJC Scopus subject areas

  • General Nursing
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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