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

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.