Characteristics and treatment of Multiple Sclerosis-related trigeminal neuralgia: An Italian multi-centre study

Viviana Nociti, Diana Ferraro, Pietro Annovazzi, Marcello Moccia, Roberta Lanzillo, Giovanna De Luca, Roberta Fantozzi, Damiano Paolicelli, Paolo Ragonese, Alberto Gajofatto, Laura Boffa, Paola Cavalla, Salvatore Lo Fermo, Maria Chiara Buscarinu, Lorena Lorefice, Cinzia Cordioli, Massimiliano Calabrese, Antonio Gallo, Federica Pinardi, Carla TortorellaMassimiliano Di Filippo, Valentina Camera, Giorgia Teresa Maniscalco, Marta Radaelli, Fabio Buttari, Valentina Tomassini, Eleonora Cocco, Claudio Gasperini, Claudio Solaro

Risultato della ricerca: Contributo in rivistaArticolo in rivista

7 Citazioni (Scopus)

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.
Lingua originaleEnglish
pagine (da-a)101461-101461
Numero di pagine1
RivistaMultiple Sclerosis and Related Disorders
Volume37
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Multiple Sclerosis
  • Pain
  • Analgesics, Non-Narcotic
  • Microvascular Decompression Surgery
  • Trigeminal neuralgia

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