Burden of illness of trigeminal neuralgia among patients managed in a specialist center in England

The Journal of Headache and Pain

Lasair O’Callaghan¹  Lisa Vinikoor-Imler¹  Lysbeth Floden²  Chris Hartford²  Tara Symonds³  Kathryn Giblin⁴  Joanna M. Zakrzewska⁵ 

[1] Biogen, 225 Binney St, 02142, Cambridge, MA, USA;Clinical Outcomes Solutions, 1820 E. River Rd., Suite 220, 85718, Tucson, AZ, USA;Clinical Outcomes Solutions, Unit 68, Basepoint, Shearway Road, Shearway Business Park, Folkestone, CT19 4RH, Kent, UK;Formerly Biogen, 225 Binney St, 02142, Cambridge, MA, USA;Royal National ENT & Eastman Dental Hospitals, 4th Floor Central, 250 Euston Road, NW1 2PQ, London, UK;UCLH NHS Foundation Trust, Oral theme of the UCL/UCLH NIHR Biomedical Research Centre UK, London, UK;

关键词: Trigeminal neuralgia;    Trigeminal nerve;    Facial pain;    Microvascular decompression;    Multidisciplinary approach;    Patient related outcomes;   

DOI  :  10.1186/s10194-020-01198-z

来源: Springer

【 摘 要 】

BackgroundTrigeminal neuralgia (TN) causes severe episodic, unilateral facial pain and is initially treated with antiepileptic medications. For patients not responding or intolerant to medications, surgery is an option.MethodsIn order to expand understanding of the pain-related burden of illness associated with TN, a cross-sectional survey was conducted of patients at a specialist center that utilizes a multidisciplinary care pathway. Participants provided information regarding their pain experience and treatment history, and completed several patient-reported outcome (PRO) measures.ResultsOf 129 respondents, 69/128 (54%; 1 missing) reported no pain in the past 4 weeks. However, 84 (65%) respondents were on medications, including 49 (38%) on monotherapy and 35 (27%) on polytherapy. A proportion of patients had discontinued at least one medication in the past, mostly due to lack of efficacy (n = 62, 48%) and side effects (n = 51, 40%). A total of 52 (40%) patients had undergone surgery, of whom 30 had microvascular decompression (MVD). Although surgery, especially MVD, provided satisfactory pain control in many patients, 29% of post-surgical patients reported complications, 19% had pain worsen or stay the same, 48% were still taking pain medications for TN, and 33% reported new and different facial pain.ConclusionsIn most PRO measures, respondents with current pain interference had poorer scores than those without pain interference. In the Patient Global Impression of Change, 79% expressed improvement since beginning of treatment at this clinic. These results indicate that while the multidisciplinary approach can substantially alleviate the impact of TN, there remains an unmet medical need for additional treatment options.

【 授权许可】

CC BY