Abstract
Context: Trigeminal neuralgia is as a chronic, debilitating condition, which can have a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental populations. Objectives: To evaluate the retrospective data of the patients diagnosed with idiopathic trigeminal neuralgia and to understanding the disorder in the Indian populace. Methods: The retrospective data of 72 patients with typical idiopathic trigeminal neuralgia regarding age of onset, gender, site of involvement, clinical presentations and treatment received during three years of the follow up was collected and analyzed. Results: In the present retrospective study, the mean age was 54.9 years; female to male ratio was 2.13:1; rural to urban ratio 1.76:1 with 62.5% suffered trigeminal neuralgic pain on the right side. Carbamazepine was found to be highly effective in 60.8% of the cases on long-term basis with maintenance doses. Other treatment modalities were employed in more refractory cases including add-on of gabapentin, which relieved the symptoms for an additional duration of 13±3months. The neurolytic alcohol bloc was given in 30% of patients who stopped responding to combination of carbamazepine and gabapentin and relieved pain for a mean duration of 17.25±2.95 months. Twenty three percent of the patients (23%) required peripheral neurectomy. Conclusions: Carbamazepine was found to be highly effective in trigeminal neuralgia. Other treatment modality includes add-on of gabapentin, neurolytic alcohol blocs and peripheral surgical intervention in more refractory cases. Only limited cases needed further neurological consideration. Key words:Trigeminal neuralgia, carbamazepine, gabapentin, alcohol bloc, peripheral neurectomy.
Highlights
Trigeminal neuralgia is as a chronic, debilitating condition resulting in brief and intense episodes of facial pain in the distribution of one or more branches of the fifth cranial nerve [1,2,3]
Material and Methods The present retrospective study relates to a consecutive series of 72 patients with typical idiopathic trigeminal neuralgia reported in the Department of Maxillofacial Surgery at the PDM Dental College Bahadurgarh, Haryana, India
The patient diagnosed with typical idiopathic trigeminal neuralgia in the present retrospective study ranged between 34 to 76 years, with a mean age of 54.9 years
Summary
Trigeminal neuralgia is as a chronic, debilitating condition resulting in brief and intense episodes of facial pain in the distribution of one or more branches of the fifth cranial nerve [1,2,3]. Etiology may be either idiopathic or secondary to intracranial lesions such as tumor, infarction and multiple sclerosis. Intracranial lesions that cause compression or traction of the trigeminal nerve are uncommon, but are a recognized cause of secondary trigeminal neuralgia. Patients with multiple sclerosis may develop trigeminal neuralgia; it is relatively rare. The estimated annual incidence of trigeminal neuralgia is 12.6 per 100000 persons per year [4] and its incidence increases with age. Literature suggested a strong preponderance in women; current data indicate that only approximately 60% of patients with trigeminal neuralgia are female [5]. Because of the paucity of Indian data on incidence and management, a retrospective study of patients was undertaken with the purpose of understanding the disorder in the local context, and to compare with published data
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