目的 :观察托吡酯治疗头面部神经痛的疗效及安全性。方法 :将 58例头面部神经痛病人随机分为托吡酯组 30例 ,卡马西平组 2 8例。托吡酯组起始剂量 2 5mg ,po ,bid ,根据病情每周加用 2 5mg。卡马西平组起始剂量 10 0mg ,po ,bid ,根据病情每周加用 10 0mg。疼痛缓解 2wk后停服并继续随访2wk ,治疗后wk 3统计总有效率。结果 :托吡酯组及卡马西平组缓解时间分别为 6.1d± 2 .7d及 7.1d± 2 .0d(P >0 .0 5) ,总有效率分别为 87%及 86%(P >0 .0 5)。不良反应发生率分别为 10 %及 7%。托吡酯组不良反应表现为头晕、感觉异常、嗜睡、视物模糊。结论 :托吡酯是治疗头面部神经痛有效、不良反应少的药物 Objective: To observe the efficacy and safety of topiramate in the treatment of head and facial neuralgia. Methods: Fifty-eight patients with head and facial neuralgia were randomly divided into topiramate group (n = 30) and carbamazepine group (n = 28). Topiramate group initial dose of 25mg, po, bid, according to the disease weekly plus 25mg. Carbamazepine group initial dose 10 0mg, po, bid, according to the disease weekly plus 10mg. 2wk pain relief after stopping and continue to follow-up 2wk, wk 3 total effective rate after treatment. Results: The remission time of topiramate group and carbamazepine group was 6.1d ± 2. 7d and 7.1d ± 2.0d, respectively (P> 0.05), the total effective rates were 87% and 86%, respectively. 0 5). The incidence of adverse reactions were 10% and 7%. Topiramate group showed adverse reactions dizziness, sensory abnormalities, lethargy, blurred vision. Conclusion: Topiramate is effective in treating head and facial neuralgia and has few adverse reactions