Clinical features of trigeminal neuralgia: a 10-year retrospective study

Aims: Trigeminal neuralgia (TN) is a disorder that is debilitating and significantly affects the quality of life, however there were several studies with small number of patients withTN in different populations and detailed information about clinical features was usually inadequate. In this study we aimed to retrospectively evaluate the clinical features, imaging findings and treatment options in patients with TN in a tertiary care hospital and to determine the characteristics that affect the response to medical treatment. Methods: 458 patients with a preliminary or primary diagnosis ICD code of G50 in between 2011-2021 years were retrospectively investigated. Demographic data of the patients, medical conditions, clinical characteristics of TN, treatment modalities were recorded. Recurrence and response to medical treatment of the patients with a follow up period were assessed. The statistical analysis was performed with SPSS Version 26. The characteristics affecting the response to medical treatment were examined. p <0.05 was accepted as statistically significant. Results: The majority of patients were female and between the ages of 50-70. 57.9% of the patients had unilateral right neuralgia, and the pain was most frequently localized to the V2 and/or V3 divisions. 69.9% of the patients had pain that affected their daily activities. The most common abnormal finding in MRI was superior cerebellar artery compression (6.0%). Carbamazepine was the most commonly preferred drug, and 40.6% of the patients were seen to use polytherapy. 29 patients (21.8%) had total relief and 55 patients (41.4%) described partial relief. The difference between the response to medical treatment and age groups was statistically significant (p=0.008). No difference was observed between the gender and invasive method use in the patients' response to medical treatment but statistically significant difference was observed between patients receiving polytherapy and the treatment response (p=0.009). Conclusion: TN can be encountered in many clinics and its diagnosis can be confused with many diseases. Therefore, recognition of the disease and early treatment are important. Studies on the clinical features, treatment options and prognosis of TN should be increased. Delay in diagnosis and treatment has great importance both on the health system and on the patient's quality of life and daily life activities.