Clinical and Radiological Profile of Trigeminal Neuralgia- A Retrospective StudyCorrespondence Address :
Department of Neurology, Travancore Medical College, Kollam-691020, Kerala, India.
Introduction: Trigeminal neuralgia is described as severe, stabbing unilateral pain along the distribution of trigeminal nerve branches. The three subtypes include- Classical, secondary and idiopathic.
Aim: To study the clinical profile, presentation and radiological imaging features in trigeminal neuralgia patients.
Materials and Methods: This cross-sectional study included outpatient medical records of 60 trigeminal neuralgia patients between June 2015 to June 2020 (five years) in a Tertiary care Medical College Hospital. Various parameters studied were: (a) Age; (b) Gender; (c) Dental treatment; (d) Pain severity; (e) Trigger factors; (f) Side and branch involved; (g) Sensory abnormalities; (h) MRI. Data was entered in Microsoft excel and analysed using SPSS statistical software 20.0. Chi-square test was used for categorical variables.
Results: Among the 60 patients studied, the common demographic and clinical features were as follows: 34 were females (56.7%); 36 with right side presentation (60%); 25 had maxillary nerve division distribution (41.7%); 57 patients experienced shock/lancinating pain (95%); and 40 had Numeric pain severity scale of 4-6 (66.7%). Classical trigeminal neuralgia was the most common subtype seen in 31 patients (51.7%). Involvement of dual divisions (maxillary and mandibular), absence of trigger factors and presence of hypoesthesia were more suggestive of Secondary Trigeminal neuralgia (p<0.05). Based on MRI imaging, 31 (51.7%) showed neurovascular compression with atrophy or displacement of trigeminal nerve root. Only 5 (8.4%) had secondary causes (schwannoma, meningioma, demyelination, infarct).
Conclusion: The key clinical features of trigeminal neuralgia include female preponderance, right side presentation, maxillary nerve division distribution, shock/lancinating pain with touch and breeze as common trigger factors. As some of them had a previous dental treatment or procedure, dentists need to be aware of this entity. Certain clinical features would help to differentiate the secondary from classic and idiopathic neuralgia subtype.
Cephalalgia, Facial pain, Lancinating, Secondary trigeminal neuralgia
Date of Submission: Sep 16, 2020
Date of Peer Review: Sep 30, 2020
Date of Acceptance: Oct 13, 2020
Date of Publishing: Nov 01, 2020
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Sep 18, 2020
• Manual Googling: Oct 13, 2020
• iThenticate Software: Oct 28, 2020 (21%)
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