Characterization of patients with trigeminal neuralgia in a Mexican hospital, 2009-2019

Abstract

Background: Trigeminal neuralgia (TN) is a stereotyped, repetitive, paroxysmal pain, with annual prevalence 4-13%. Objective: To describe clinical and therapeutic characteristics of patients diagnosed with TN, Palliative Care Division, Pain Clinic, Hospital “Dr. Manuel Gea González”. Methods: Retrospective descriptive study. Review of 91 records, January 1, 2009, to December 31, 2019, 33 patients who abandoned treatment were eliminated, obtaining a convenience sample (61). Results: Female sex was more affected 62.3% (38), compared to male 37.7% (23), ratio 1.6 / 1. Mean age 60.2±16.8 years. The evolution prior to care had a mean: 17.6 months. The trigeminal branches affected were left branch combinations 36.1% (22), right branch 27.9% (17), right maxillary 13.1% (8). Secondary causes were: 55.7% (35): post-traumatic 11, post-herpetic 7, vascular compression 8, tumors 4, and temporomandibular dysfunction 5. Comorbidities were arterial hypertension, diabetes mellitus type 2. They received previous pharmacological therapy with non-steroidal anti-inflammatory drugs 31.6% (37). At admission the pain intensity was severe 96.7% (59), moderate 3.3% (2). Inhospital treatment received was carbamazepine 86.8% (53) and gabapentinoids 60.6% (37). Discharged without pain 24.6% (15), with mild pain 57.4% (35), moderate pain 13.1% (8), and severe pain 4.9% (3). Discussion: TN was more frequent in women, between 50 and 70 years of age, similar to that reported. The time of symptom onset and evaluation specialist in Algology was prolonged. Pharmacological treatment indicated: carbamazepine, gabapentinoids, opioids and antidepressants, according to the Neuropathic Pain Management Guidelines.