Does Dalfampridine Reactivate Trigeminal Neuralgia in People with Multiple Sclerosis?

Dalfampridine, an extended-release formulation of the potassium channel blocker 4-aminopyridine, is licensed in the U.S. as a symptomatic therapy to improve walking speed in people with multiple sclerosis (MS). Dalfampridine may also provide symptomatic benefit in other functional neurologic domains in patients with MS and other neurologic diseases. A new case series suggests that dalfampridine may aggravate or trigger trigeminal neuralgia.

Of 71 patients with clinically definite MS in an MS subspecialty practice who had been prescribed dalfampridine for the on-label indication, 3 had histories of trigeminal neuralgia and 2 had histories of unilateral episodic altered facial sensation. Of the 3 patients with prior trigeminal neuralgia, all o…