Trigeminal neuralgia--a prospective systematic study of clinical characteristics in 158 patients

Headache. Nov-Dec 2014;54(10):1574-82. doi: 10.1111/head.12441. Epub 2014 Sep 18.

Abstract

Objective: To prospectively describe the clinical characteristics of classical trigeminal neuralgia (TN) in a standardized manner.

Background: TN is a rare disease and most clinicians only see a few patients. There is a lack of prospective systematic studies of the clinical characteristics of TN. We hypothesized that contrary to current thinking, some TN patients suffer from sensory abnormalities at neurological examination.

Methods: Clinical characteristics such as demographics, pain characteristics, and comorbidities were systematically and prospectively collected from consecutive TN patients in a tertiary referral center in a cross-sectional study.

Results: A total of 158 patients were included. Average age of onset was 52.9 years. TN was more prevalent in women (95; 60%) than in men (63; 40%), P = .011, and more often located on the right (89; 56%) than on the left side (64; 41%), P = .043. It affected solely the second and/or third trigeminal branch in 109 (69%) while the first branch alone was affected in only 7 (4%). Notably, 78 (49%) had concomitant persistent pain in addition to paroxysmal stabbing pain. Autonomic symptoms were present in 48 (31%). Patients who had not undergone surgery for TN had sensory abnormalities in 35 (29%).

Conclusions: This, the first study in a series of papers focusing on the clinical, radiological, and etiological aspects of TN, revealed that the symptomatology of TN includes a high percentage of concomitant persistent pain, autonomic symptoms, and sensory abnormalities. These findings offer new insights to the prevailing clinical impression of the clinical characteristics in TN.

Keywords: autonomic symptoms; clinical characteristics; sensory abnormalities; trigeminal neuralgia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Community Health Planning
  • Comorbidity
  • Denmark
  • Female
  • Functional Laterality
  • Humans
  • Male
  • Middle Aged
  • Mood Disorders / etiology
  • Pain Measurement
  • Prospective Studies
  • Sensation Disorders / etiology
  • Sex Distribution
  • Sodium Channel Blockers / therapeutic use
  • Trigeminal Neuralgia / complications
  • Trigeminal Neuralgia / diagnosis*
  • Trigeminal Neuralgia / epidemiology
  • Trigeminal Neuralgia / therapy*

Substances

  • Sodium Channel Blockers