Characteristics and treatment of Multiple Sclerosis-related trigeminal neuralgia: An Italian multi-centre study.

Publication date: Jan 01, 2020

The prevalence of trigeminal neuralgia (TN) in Multiple Sclerosis (MS) patients is higher than in the general population and its management can be particularly challenging. Our aim is to describe the characteristics, treatment and prognostic factors of MS-related TN in a retrospective multicentre study.

Neurologists members of the RIREMS group (Rising Researchers in MS) enrolled MS patients with a TN diagnosis and filled out a spreadsheet comprising their clinical data.

Population consisted of 298 patients. First-choice preventive treatments were carbamazepine and oxcarbazepine. A surgical procedure was performed in 81 (30%) patients, most commonly gamma knife stereotactic radiosurgery (37%), followed by microvascular decompression (22%) and radiofrequency thermocoagulation (21%); one third of patients underwent at least two procedures. Surgery was associated with higher disability, male sex and longer interval between MS and TN onset. Patients (77%) who stayed on at least one preventive medication at most recent follow-up, after a mean period of 8 years, had a higher disability compared to the untreated group. Furthermore, patients with higher disability at TN onset were less likely to discontinue their first preventive medication due to pain remission, had bilateral TN more frequently and underwent surgical interventions earlier.

MS patients with a higher disability at TN onset and with a longer interval between MS and TN onset had differing clinical features and outcomes: pain was more frequently bilateral, surgery was more frequent and anticipated, and preventive medication discontinuation due to pain remission was less common.

Ferraro, D., Annovazzi, P., Moccia, M., Lanzillo, R., De Luca, G., , Nociti, Fantozzi, R., Paolicelli, D., Ragonese, P., Gajofatto, A., Boffa, L., Cavalla, P., Lo Fermo, S., Buscarinu, M.C., Lorefice, L., Cordioli, C., Calabrese, M., Gallo, A., Pinardi, F., Tortorella, C., Di Filippo, M., , Camera, Maniscalco, G.T., Radaelli, M., Buttari, F., , Tomassini, Cocco, E., Gasperini, C., Solaro, C., and Sclerosis), RIREMS (Rising. Researchers. in. Multiple. Characteristics and treatment of Multiple Sclerosis-related trigeminal neuralgia: An Italian multi-centre study. 20487. 2020 Mult Scler Relat Disord (37):

Concepts Keywords
Carbamazepine Untreated
Disability Pain
First Choice MS
Gamma Knife Surgery
Italian Thermocoagulation
Multiple Sclerosis Stereotactic radiosurgery
Oxcarbazepine Organ systems
Pain Nervous system
Radiofrequency Pain
Remission Medicine
Spreadsheet Neurological disorders
Stereotactic Radiosurgery RTT
Trigeminal Neuralgia Rare diseases
Trigeminal neuralgia
Multiple sclerosis
Microvascular decompression
Trigeminal nerve


Type Source Name
disease MESH Multiple Sclerosis
disease MESH trigeminal neuralgia
disease MESH diagnosis
drug DRUGBANK Carbamazepine
drug DRUGBANK Oxcarbazepine


Original Article

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