A structured medical management program was found to improve outcomes in patients with trigeminal neuralgia after 2 years, according to a study published in The Journal of Headache and Pain.

The study included participants enrolled in a structured management program at a specialist center for facial pain (n=186). The program consisted of optimization of medical treatment, physiotherapy, psychotherapy, and advice from trained nurses. Medically intractable participants were referred for neurosurgery.

Data were prospectively collected using standardized schemes and patient surveys. The primary outcome was a 50% reduction in the overall burden of pain assessed with a 0 to 10 numeric rating scale (NRS) 2 years after enrollment in the program.

Of 186 enrolled participants, 103 completed the 2-year follow-up. Of these, 50 patients were treated surgically during the follow-up period.

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The mean burden of pain decreased from 5.34 to 3.00 (P <.01). Over the 2-year period, 51% (n=53) of participants who were medically managed reported >50% reduction in the overall burden of pain. At the 2-year follow-up vs baseline, more participants reported no overall burden of pain (ie, NRS score of 0; 16 vs 2 patients, respectively; P <.002) and mild burden of pain (ie, NRS score of 1-4; 63 vs 38 patients, respectively; P =.002).

No association was established between the primary outcome and sex, depression and/or anxiety, concomitant persistent pain, or neurovascular contact with morphologic changes in the trigeminal nerve.

“Findings indicate that [trigeminal neuralgia] is not an invariably progressive disease and provides optimism and hope to clinicians and patients that medical treatment of [trigeminal neuralgia] by experts is highly rewarding,” the researchers noted.

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Reference

Heinskou TB, Maarbjerg S, Wolfram F, et al. Favourable prognosis of trigeminal neuralgia when enrolled in a multidisciplinary management program – a two-year prospective real-life study [published online March 4, 2019]. J Headache Pain. doi:10.1186/s10194-019-0973-4