TY - JOUR
T1 - Characteristics and treatment of Multiple Sclerosis-related trigeminal neuralgia: An Italian multi-centre study
AU - Ferraro, Diana
AU - Annovazzi, Pietro
AU - Moccia, Marcello
AU - Lanzillo, Roberta
AU - De Luca, Giovanna
AU - Nociti, Viviana
AU - Fantozzi, Roberta
AU - Paolicelli, Damiano
AU - Ragonese, Paolo
AU - Gajofatto, Alberto
AU - Boffa, Laura
AU - Cavalla, Paola
AU - Lo Fermo, Salvatore
AU - Buscarinu, Maria Chiara
AU - Lorefice, Lorena
AU - Cordioli, Cinzia
AU - Calabrese, Massimiliano
AU - Gallo, Antonio
AU - Pinardi, Federica
AU - Tortorella, Carla
AU - Di Filippo, Massimiliano
AU - Camera, Valentina
AU - Maniscalco, Giorgia Teresa
AU - Radaelli, Marta
AU - Buttari, Fabio
AU - Tomassini, Valentina
AU - Cocco, Eleonora
AU - Gasperini, Claudio
AU - Solaro, Claudio
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Analgesics, Non-Narcotic
KW - Microvascular Decompression Surgery
KW - Multiple Sclerosis
KW - Pain
KW - Trigeminal neuralgia
KW - Analgesics, Non-Narcotic
KW - Microvascular Decompression Surgery
KW - Multiple Sclerosis
KW - Pain
KW - Trigeminal neuralgia
UR - http://hdl.handle.net/10807/169064
U2 - 10.1016/j.msard.2019.101461
DO - 10.1016/j.msard.2019.101461
M3 - Article
SN - 2211-0348
VL - 37
SP - 101461
EP - 101461
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
ER -