Trigeminal neuralgia within the disease course of MS: Diagnostic and therapeutic implications from a multicenter cohort

Trigeminal neuralgia (TN) is commonly associated with multiple sclerosis (MS). Whether TN should be considered a clinical relapse or evidence of active disease lacks consensus. TN was diagnosed in 0.9%-1.9% (<i>n</i> = 171) of people with multiple sclerosis (pwMS) at three international sites. In 9.9%, TN was their first potential demyelinating symptom. In 86%, TN onset occurred a median of 13-16 years after MS diagnosis. A clinical relapse occurred within 6 months of TN onset in 20% of pwMS. These data suggest TN onset should be evaluated as active disease and incorporated in diagnostic and therapeutic decisions in MS.