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Concomitant persistent pain in classical trigeminal neuralgia--evidence for different subtypes
Stine Maarbjerg1, Aydin Gozalov, Jes Olesen
1Danish Headache Center, Department of Neurology, Glostrup University Hospital, Glostrup, Denmark.
Headache
|May 21, 2014
Summary
Trigeminal neuralgia (TN) with persistent pain is common and distinct. This phenotype presents earlier, more often in women, and with sensory changes, differing from TN without persistent pain.
Area of Science:
- Neurology
- Pain Medicine
- Headache Disorders
Background:
- Debate exists on the clinical significance of persistent pain in trigeminal neuralgia (TN).
- The 3rd International Classification of Headache Disorders (ICHD-3) beta classification distinguishes TN with and without concomitant persistent pain.
- Understanding these distinctions is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To characterize the clinical features of classical trigeminal neuralgia (TN) with concomitant persistent pain.
- To determine if TN with concomitant persistent pain constitutes a distinct clinical phenotype.
Main Methods:
- A cross-sectional study involving 158 consecutive TN patients.
- Systematic and prospective collection of clinical data.
- Comparison of characteristics between TN with and without concomitant persistent pain.
Main Results:
- 49% of TN patients experienced concomitant persistent pain.
- This subgroup was younger at onset (6.2 years younger) and predominantly female.
- TN with persistent pain showed more sensory abnormalities and less response to sodium channel blockers.
Conclusions:
- Concomitant persistent pain is a prevalent feature of TN, not solely a result of paroxysmal pain.
- The ICHD-3 beta classification differentiating TN with and without persistent pain is clinically and scientifically supported.
- These findings highlight TN with persistent pain as a distinct and important phenotype.