Trigeminal neuralgia: diagnostic criteria, clinical aspects and treatment outcomes. A retrospective study.

Objective: The aim of this study was to investigate the diagnostic criteria and clinical presentations and compare the different treatment modalities in relation to prognosis in a sample of patients with the neuropathic disorder trigeminal neuralgia (TN).

Methods: A retrospective review study of clinical records was conducted of 92 patients diagnosed with TN.

Results: The mean age[±standard deviation (SD)] of the patients was 67.3±12.7 years with an average TN duration of 7.1±6 years and a female predominance (M:F=1:2.5). The maxillary branch was the most involved nerve (in 45% of patients). Twelve patients underwent CT scans, while thirty-six patients had MRIs. Carbamazepine used by 92.4% of patients was the most commonly used drug in the management of the disorder. Twenty-two patients had microvascular decompression (MVD). TN symptoms were completely relieved following surgery in 73% of patients who underwent neurosurgery.

Conclusions: MRI is highly sensitive in the exclusion of central intracranial lesions and recommended as a routine consideration during the assessment of TN patients. Despite the side effects, carbamazepine is the drug therapy of choice. MVD produces satisfactory relief of TN symptoms in the majority of cases and should be offered to young healthy patients.