Trigeminal neuralgia-like pain in a vagus nerve stimulation super-responder with drug-resistant idiopathic generalized epilepsy: A case report

• VNS is an effective adjunctive treatment in drug-resistant IGE. • TNLP is a rare side effect of VNS therapy. • Pharmacological treatment may be needed if TNLP persists after reprogramming. We report a 38-year-old man with drug-resistant idiopathic generalized epilepsy (IGE) who became seizure-free after being implanted with vagus nerve stimulation (VNS). He developed a trigeminal neuralgia-like pain (TNLP) time-locked with ON stimulations. TNLP did not cease after restoring the initial stimulation parameters. After an unsuccessful trial with carbamazepine, the patient reported a moderate improvement with pregabalin. He remained seizure-free, being able to partially rationalize his ASM therapy and the ability to start driving lessons, with the normalization of his routine electroencephalogram (EEG).