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RESEARCH PRODUCT
Characteristics and treatment of Multiple Sclerosis-related trigeminal neuralgia: An Italian multi-centre study
Giorgia Teresa ManiscalcoCinzia CordioliMaria Chiara BuscarinuDiana FerraroMassimiliano Calabrese 1Claudio GasperiniMarcello MocciaAlberto GajofattoAntonio GalloEleonora Cocco 2Valentina CameraPietro AnnovazziRoberta FantozziMarta RadaelliGiovanna De Luca 2Valentina TomassiniRoberta Lanzillo 2Claudio SolaroLorena LoreficeCarla TortorellaFederica PinardiFabio ButtariPaolo RagonesePaola CavallaViviana NocitiSalvatore Lo FermoLaura BoffaRiremsDamiano PaolicelliMassimiliano Di Filipposubject
Pediatricsmedicine.medical_treatmentmultiple sclerosismicrovascular decompression surgerytime factors0302 clinical medicineRadiofrequency thermocoagulationTrigeminal neuralgiaMultiple SclerosiOutcome Assessment Health Careitalymiddle agedpain030212 general & internal medicineOxcarbazepinehumanseducation.field_of_studytrigeminal neuralgiaadultDisability; Multiple Sclerosis; Pain; Trigeminal neuralgiaradiosurgeryGeneral MedicineAnalgesics Non-Narcotichealth carefollow-up studiesSettore MED/26 - NEUROLOGIAagedretrospective studiesfemaleNeurologydisability; multiple sclerosis; pain; trigeminal neuralgia; adult; aged; analgesics non-narcotic; female; follow-up studies; humans; italy; male; microvascular decompression surgery; middle aged; multiple sclerosis; radiosurgery; retrospective studies; severity of illness index; sex factors; time factors; trigeminal neuralgia; neurosurgical procedures; outcome assessment health careanalgesicsTrigeminal neuralgiamedicine.drugmedicine.medical_specialtyMultiple SclerosisPopulationPainMicrovascular decompression03 medical and health sciencesmalemedicineseverity of illness indexeducationoutcome assessmentDisabilitybusiness.industryMultiple sclerosisCarbamazepinemedicine.diseaseneurosurgical proceduresDiscontinuationsex factorsdisabilitynon-narcoticNeurology (clinical)business030217 neurology & neurosurgerydescription
Abstract Background The prevalence of trigeminal neuralgia (TN) in Multiple Sclerosis (MS) patients is higher than in the general population and its management can be particularly challenging. Our aim is to describe the characteristics, treatment and prognostic factors of MS-related TN in a retrospective multicentre study. Methods Neurologists members of the RIREMS group (Rising Researchers in MS) enrolled MS patients with a TN diagnosis and filled out a spreadsheet comprising their clinical data. Results Population consisted of 298 patients. First-choice preventive treatments were carbamazepine and oxcarbazepine. A surgical procedure was performed in 81 (30%) patients, most commonly gamma knife stereotactic radiosurgery (37%), followed by microvascular decompression (22%) and radiofrequency thermocoagulation (21%); one third of patients underwent at least two procedures. Surgery was associated with higher disability, male sex and longer interval between MS and TN onset. Patients (77%) who stayed on at least one preventive medication at most recent follow-up, after a mean period of 8 years, had a higher disability compared to the untreated group. Furthermore, patients with higher disability at TN onset were less likely to discontinue their first preventive medication due to pain remission, had bilateral TN more frequently and underwent surgical interventions earlier. Conclusion MS patients with a higher disability at TN onset and with a longer interval between MS and TN onset had differing clinical features and outcomes: pain was more frequently bilateral, surgery was more frequent and anticipated, and preventive medication discontinuation due to pain remission was less common.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-07-05 |