Trigeminal neuralgia in multiple sclerosis patients: a clinical comparison of trigeminal neuralgia in patients with and without underlying multiple sclerosis

Abstract

Background: The prevalence of trigeminal neuralgia (TN) is higher in multiple sclerosis (MS) as compared in the general population. Clinical and treatment responses of MS patients compared with non-MS patients are in debate. Objective: To evaluate clinical differences in trigeminal pain presentation and pharmacological treatment response in patients with and without underlying MS. Material and methods: A retrospective study of 10 MS patients that had TN as a first symptom or in the MS course (from the total 545 MS patients). Data regarding MS (sex, age at MS onset, type, symptomatology, number and site of lesions on brain MRI, treatment) and TN (clinical characteristics of facial pain, treatment), period from TN as a clinically isolated syndrome to defined MS or period from MS onset to TN beginning were analyzed. Clinical, demographical and treatment response were compared with corresponding data of 10 consecutive patients hospitalized for idiopathic TN. Results: The only difference between MS and non-MS patients was the age of onset of TN (41.8 ±6.12 in MS vs 52.7±16.5 in non –MS patients, p=0.07, unpaired Student’s t-test). There are no differences in trigeminal pain characteristics between MS and non-MS patients. Conclusions: TN among MS patients has an onset at younger age but share the same pain characteristics and treatment responds with TN in the general population. TN in MS has multiple mechanisms of aetiopathogenesis and surgical treatment must be held in mind in selected cases.