Clinical insights and treatment challenges in trigeminal neuralgia from a retrospective cohort study

Background: Trigeminal neuralgia (TN) is a severely incapacitating condition marked by recurrent, intense facial pain. This disorder significantly diminishes patients’ quality of life and is frequently misdiagnosed, owing to symptomatic similarities with other facial pain conditions. The present study aims to meticulously examine the demographic profiles, prevalence of concurrent systemic illnesses, specific pain characteristics, and therapeutic responses among TN patients, enhancing diagnostic precision and optimizing treatment strategies. Methods: A retrospective study was conducted at the Chronic Orofacial Pain Clinic, Oral Diagnostic Department, Kerman, Iran. This study analyzed data collected from TN patients who were diagnosed between 2016 and 2022, adhering to the International Headache Society criteria. Patient demographics, systemic health conditions, pain characteristics, and treatment outcomes were thoroughly assessed. Statistical analysis was performed using SPSS 26, with Chi-square tests employed to determine statistical significance. Results: This study involved a cohort of 81 patients, predominantly female (69.1%), with a mean age of 52 years (age range: 25 to 81 years). Systemic conditions were observed in 66.70% of patients (P=0.003), with hypertension being the most prevalent (22.20%, P<0.001). The maxillary branch (V2) was identified as the most frequently affected anatomical site (43.20%, P<0.001). The pain experienced by participants was overwhelmingly unilateral (97.50%, P<0.001). Patients characterized the pain using several descriptors, most commonly as electric shock-like (56.80%), piercing/stabbing (54.30%), and radiating (51.90%). Significant triggers for this pain encompassed touching the affected site (59.2%, P=0.098) and speaking (35.8%, P=0.011). Significant sleep disturbances were observed within the patient cohort. Specifically, 22.2% of patients reported difficulty initiating sleep (P<0.001), and 29.6% experienced problems with sleep maintenance (P=0.004). Regarding treatment outcomes for TN, 26.90% of patients achieved full recovery (P<0.001), while 55.70% demonstrated relative recovery. Conclusion: The current research underscores the intricate symptoms and profound influence of TN on patients’ daily lives, highlighting the critical need for specialized treatment approaches. The enhancement of diagnostic criteria and the development of personalized management plans are crucial for improving treatment efficacy and patients’ overall quality of life. Additionally, further research is warranted to investigate a potential correlation between TN and myalgia, which could lead to novel therapeutic strategies.