Abstract text (incl. figure legends and references)

Objectives

The aim of the study is to describe the most frequent etiologies and the pain qualities in a sample of patients with secondary trigeminal neuralgia (TN).

Methods

Observational, descriptive, retrospective, and single-center study that includes all secondary TN followed up for a mean of 5 years in the Headache Unit of a tertiary hospital.

Results

39 patients diagnosed with secondary TN with a mean age of 54 years were included. The main etiologies found in our sample were tumors 41% (meningioma 38%, squamous cell tumor 25%, schwannoma 25% and glioma 13%) and multiple sclerosis (MS) 41% (88% due to pontine plaques, only 8% active plaques). The remaining 18% were related to nonspecific demyelinating lesions without MS criteria, ischemic lesions, post-surgery, pachymeningitis, hemangioma, and Arnold-Chiari malformation.

Regarding the pain pattern, most of the patients suffered Burchiel type 1 neuropathic pain (77%) and the involvement of more than one branch predominated: 2 branches in 41% of the patients and three branches in 21%. The most affected branch was V3 (77%), followed by V2 (67%).

The most used drugs were carbamazepine and its derivatives (79%), with an effectiveness of 45% for more than two years, followed by gabapentinoids (67%), with an effectiveness of 11%, and lacosamide (41%), with an effectiveness of 0%. 28% of the patients underwent percutaneous surgery and 10% underwent microvascular decompression surgery.

Conclusions

The most frequent causes of secondary TN were intracranial tumors and MS. Secondary TN more often affects 2 or more trigeminal branches. The most effective drugs were carbamazepine and its derivatives.