Clinical Characteristics of Patients with Trigeminal Neuralgia Referred to Neurosurgery

Siqueira, Sílvia Regina Dowgan Tesseroli de; Teixeira, Manoel Jacobsen; Siqueira, José Tadeu Tesseroli de

doi:10.1055/s-0039-1697433

Cited by 41 publications

(25 citation statements)

References 19 publications

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“…This is compared with a prevalence rate of only 58/100,000 (0.058%) in the US population overall. 44 We noted that the proportion of women was slightly higher in this study than for the TN population reported in other literature 71.8% vs ~60% 6,8,45 , respectively) and the authors' own practices, most likely due to the fact that women are more likely to access care and typically live longer than men.…”

Section: Opioidscontrasting

confidence: 54%

Characterizing Treatment Utilization Patterns for Trigeminal Neuralgia in the United States

Zakrzewska

Lee

et al. 2018

The Clinical Journal of Pain

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Background and aim: Trigeminal neuralgia (TN) is a rare orofacial disorder characterized by severe unilateral paroxysmal pain in the region of the fifth cranial nerve. Clinical guidelines recommend carbamazepine (only US Food and Drug Administration-approved drug for TN) and oxcarbazepine as first-line therapies. We utilized the US Truven Health MarketScan ® database to examine treatment patterns among patients with TN. Methods: Included patients were aged ≥18 years, newly diagnosed with TN (≥2 TN diagnoses ≥14 days apart; no diagnosis in the prior year), continuously enrolled 1 year preindex, with ≥3 years' follow-up post-index. We assessed utilization of selected pharmacotherapies (carbamazepine, oxcarbazepine, pregabalin, gabapentin, baclofen, duloxetine, topiramate), surgery (posterior fossa, radiosurgery), and injections (peripheral anesthetic injections, Gasserian ganglion procedures) for TN. Results: 3685 patients were included (2425 commercial, 1260 Medicare; 71.8% female; mean[SD] age, 59[15] years). Overall, 72.5% of patients received at least 1 studied medication, most commonly carbamazepine (51.7%) or gabapentin (48.6%). Sixty-five percent of pharmacologically treated patients had ≥2 treatment episodes; 41.6% had ≥3 (defined by a change in pharmacotherapy [monotherapy/combination] regimen). Overall, 12.3% had surgery and 7.3% injections; 42.9% received opioids for TN. Conclusions: In the 3 years after diagnosis, patients with TN in the United States receive a variety of pharmacological treatments, including opioids, despite carbamazepine being the only approved medication. A notable proportion utilize surgeries/injections. A high proportion of pharmacologically treated patients receive multiple treatment episodes, suggesting frequent therapy switching, perhaps due to suboptimal efficacy/tolerability. Our data suggest a high burden of illness associated with TN.

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Section: Opioidscontrasting

confidence: 54%

Characterizing Treatment Utilization Patterns for Trigeminal Neuralgia in the United States

Zakrzewska

Lee

et al. 2018

The Clinical Journal of Pain

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“…Only 1 (0.47%) patient presented with bilateral affliction. This finding is similar in those of other studies as well (Katusic et al, ; Loh et al, ; Siqueira, Teixeira, & Siqueira, ). Overall, RV3 (35.19%) was the most frequently affected division, followed by LV3 (25.93%), RV2 (14.35%) and LV2 (12.04%).…”

Section: Discussionsupporting

confidence: 93%

Natural history of trigeminal neuralgia—A hospital‐based retrospective study

Debta

Sarode

et al. 2020

Oral Diseases

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Objective The objective of this study was to assess the natural history of trigeminal neuralgia (TN) and pretrigeminal neuralgia (PTN) in a hospital‐based sample using a retrospective and descriptive study design. Methods This study followed a retrospective study design, which yielded a sample size of 216 patients who were reclassified as per the new classification and diagnostic grading for practice and research proposed by the American Academy of Neurology. Based on an in‐depth analysis of patient history and the treatments administered, a possible state of PTN prior to TN development was determined. Results TN shows a female predilection with predominantly unilateral involvement. A total of 45.83% of patients had left‐side involvement with V3 primarily affected. Additionally, 11.11% of patients did not have any clinically apparent trigger zone, while 68.05% had a single trigger zone. Twenty‐one patients were found to have suspected PTN prior to TN. The time interval between PTN onset and TN development ranged from 6 months to 6 years. The PTN pain varied, and the clinical overlap between the site of PTN and the site of future TN was 100%. Conclusion An in‐depth patient history can serve as a reliable modality for TN diagnosis. PTN should be considered as a differential diagnosis for pain of orofacial origin because of its overlapping features with other painful conditions.

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“…Very few studies have appeared in the literature that have explored the temporal relationship between hypertension and TN. Two of these studies have reported a positive association between TN and hypertension, while 1 study was unable to show a significant association [4][5][6]. Here we describe the case of a patient who presented TN attacks precipitated by unstable blood hypertension.…”

Section: Introductionmentioning

confidence: 71%