The prevalence and clinical significance of trigeminal neuralgia in patients with multiple sclerosis

Abstract

Background & Objective: Trigeminal neuralgia (TN) is a debilitating neuropathic pain disorder characterized by sudden and intense episodes of facial pain, significantly impairing patients’ quality of life. Diagnosing TN is particularly challenging in multiple sclerosis (MS), a chronic autoimmune, demyelinating, and neurodegenerative disease affecting the central nervous system. TN in MS is predominantly caused by demyelination, axonal loss, inflammation, and brainstem lesions. However, the overlapping symptoms of TN and other craniofacial pain disorders often lead to underdiagnosis and treatment delays. This study aimed to determine the prevalence and clinical characteristics of TN in MS patients, in a cohort of Turkish patients, with a focus on diagnostic challenges and treatment patterns.

Methods: A single-center, cross-sectional survey was conducted, systematically assessing headache and facial pain symptoms among MS patients treated at the Sancaktepe Neuroimmunology Clinic, Istanbul, Turkey.

Results: The findings revealed a significant prevalence of TN (39.8%) in MS patients, with a female predominance and a mean diagnostic delay of 14 months. Despite the availability of effective treatments, a substantial proportion of patients remained undiagnosed and untreated.

Conclusion: There is urgent need to integrate routine TN screening into MS patient care to improve timely diagnosis and effective management. The study underscores the importance of a multidisciplinary approach in addressing this overlooked comorbidity, ultimately enhancing the quality of life for MS patients.