Abstract
Trigeminal neuralgia (TN) is a rare neuropathic disorder with an excruciating facial pain. The unpredictable pain attacks may result in anxiety and depression. The aim of this study was to determine and to evaluate the level of chronic facial pain and its association with the appearance of anxiety and depression. A total of 30 patients with TN and chronic facial pain (group A, 25 women and 5 men; mean age, 64.2±3.2 years) and 30 with atypical facial pain (group B, 26 women and 4 men; mean age, 64.8±1.9 years) were examined. A standardized diagnostic protocol was applied to all of them, which consisted of the following: 1) demographic data and estimation of overall pain on a visual analog scale; and 2) evaluation of emotional status using the Sheehan Disability Scale, Covi's Anxiety Scale, and Beck Depression Inventory. The intensity of facial pain was much higher in the group A than the group B (89.7±2.5 versus 44.0±2.9, P<0.0001). Besides, the group A reported increased scores on the disability and anxiety symptom scales (17.4±1.3 and 9.7±0.3 vs. 6.4±0.7 and 3.6±0.1, respectively, P<0.0001). Severe (46.7%) or moderate (30%) levels of depression were documented in the majority of patients in the group A, while the group B did not show depressive symptoms (P<0.0001). Patients with TN and chronic facial pain had a significantly higher level of pain perception, and they presented the higher level for anxiety and depression than those with atypical facial pain. A multidisciplinary approach is needed for the additional assessment of emotional status of patients in order to improve the efficacy of treatment and patients' quality of life.
Highlights
The International Association for the Study of Pain (IASP) defines trigeminal neuralgia (TN), known as “tic douloureux,” which means “painful spasm,” as a severe unilateral paroxysmal facial pain in the distribution of one or more of the branches of the fifth cranial nerve [1]
Patients with TN and chronic facial pain had a significantly higher level of pain perception, and they presented the higher level for anxiety and depression than those with atypical facial pain
A multidisciplinary approach is needed for the additional assessment of emotional status of patients in order to improve the efficacy of treatment and patients’ quality of life
Summary
The International Association for the Study of Pain (IASP) defines trigeminal neuralgia (TN), known as “tic douloureux,” which means “painful spasm,” as a severe unilateral paroxysmal facial pain in the distribution of one or more of the branches of the fifth cranial nerve [1]. Compression of the nerve root is the most commonly reported cause of the disorder, most cases are idiopathic [3]. The pain can be triggered by touching the face, brushing teeth, chewing, or even by talking and is commonly described as sudden, severe, or electric shock-like. The sudden attacks of pain may be repeated one after the other. The patient is usually asymptomatic between paroxysms, but dull background pain may persist in some cases [4, 5]. Pain-free periods may last for several months or years
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