Profiling of Patients Presenting with Trigeminal Neuralgia and Outcomes of Medical Management in a Tertiary Care Center
Sarideechaigul W, DDS, MSc, FRCDT1,4, Kitkhuandee A, MD2, Siritapetawee M, DDS, MSc1,4, Butda P, DDS, MSc3, Jorns TP, DDS, MDSc, PhD, FRCDT1,4
Affiliation : 1 Department of Oral Biomedical Sciences, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand 2 Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 3 Department of Dental Hospital, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand 4 Neuroscience Research and Development Group, Khon Kaen University, Khon Kaen, Thailand
Background : Trigeminal neuralgia (TN) is a chronic orofacial neuropathic pain that affect quality of life of the sufferers.
Objective : To describe retrospectively the clinicodemographic data of patients presenting with TN at a tertiary care center over 4-
year period. The data include its natural history, time lapse before diagnosis and outcomes of medical management.
Materials and Methods: A retrospective study was performed using 203 medical and dental records of TN patients that were
referred to the Orafacial Pain Clinic, Faculty of Dentistry and Srinagarind Hospital, Faculty of Medicine, Khon Kaen University,
Thailand over a 4-year period. The collected data were recorded using Case Record Form composing of patient demographic
information, natural history of TN, neuroimaging data and treatment modalities.
Results : 203 trigeminal neuralgia (139 females and 64 males) patient records were reviewed. The average age of onset was 52.2
years (between 16 and 85 years), the right side was the most common affected area (61.5%), and intraoral mucosa was the most
common trigger point area (54.5%) reported. The character of pain was sharp shooting, sudden onset and intermittent pain. The
time lapse before trigeminal diagnosis was less than 12 months (59.9%) while 53.4% of TN patients reported having natural remission
periods between 1 and 2 months. Carbamazepine is the most common drug prescribed (48.5%) of which 14.5% patients report
maculo-papular rash skin adverse reaction, 1.1% Stevens-Johnson syndrome/toxic epidermal necrolysis and 0.6% erythema
multiforme, respectively.
Conclusion : The present study has given some insights into the natural history of TN, notable regarding the management and its
outcome. Medical treatment, especially carbamazepine and oxcarbazepine are still the first line drugs recommended for TN; HLA-
B*1502 allele testing is strongly recommended before initiating therapy in all Asian patients.
Keywords : Trigeminal neuralgia, Natural history, Time lapse, Remission period
