Management of Trigeminal Neuralgia — Retrospective Analysis of 61 Patients from Sri Lanka

Abstract

Objectives: To identify the clinical features of idiopathic trigeminal neuralgia in hospital patients in Sri Lanka and to assess the treatment outcomes.Patients and Methods: Clinical records of 61 patients who attended the Oral Medicine Clinic at the Dental Hospital in Peradeniya, Sri Lanka, during a 4-year period from July 1998 to July 2002 were analysed. All patients were diagnosed on the basis of clinical findings and conservatively managed with medical treatment. Follow up averaged 20.2 months.Results: Trigeminal neuralgia was more common in women (57%) than in men (43 %), with a peak incidence during the fifth and sixth decades of life, and with the right side of the face involved with a greater frequency than the left side (p = 0.003). Involvement of the mandibular branch was more frequent than the maxillary branch (p = 0.015). Of the 50 patients who were initially treated with carbamazepine alone, 62% had considerable pain control within 1 month. Sixty four percent of the remaining 11 patients treated with various combinations of carbamazepine and other drugs (phenytoin sodium, sodium valproate, and amitriptyline) had a considerable degree of pain control within 1 month. However, in the long-term, carbamazepine alone was effective only for 18 patients (29.5%).Conclusions: Medical treatment was effective for controlling pain from trigeminal neuralgia. Carbamazepine alone was effective only in the initial stages of the disease, a combination of carbamazepine with other drugs proved to be effective in achieving successful pain control in the long term.