Abstract text (incl. figure legends and references)

OBJECTIVES

The aim is to describe the acute management of status due to neuralgia in patients with trigeminal neuralgia (TN) who come to the emergency room.

METHODS

Observational, descriptive, and retrospective study in which all visits to the emergency room due to neuralgia status of all patients with TN followed up in a tertiary hospital were collected. Neuralgia status was defined as TN flares in patients receiving specific pharmacological treatment. For each status episode, the rescue treatment received, the modifications in the basal treatment and the need for hospitalizations and its duration were collected.

RESULTS

From a sample of 231 patients diagnosed with TN, 43 presented at least one status episode: 16 patients diagnosed with idiopathic TN, 16 with classic TN and 11 with secondary TN (classified according to the ICHD3). The mean age was 44 years old, and the total number of statuses was 89.

Concerning the rescue treatment used, 40% of patients received first-step analgesia, 45% opioids, 18% corticosteroids, 11% antiepileptics and 3% gabapentinoids. Opioids seemed to be the more effective ones (75%), followed by antiepileptics (60%) and first-step analgesia (50%).

Hospitalization was required in 20% of status patients, with a mean stay of 8.1 days, during which optimization of the basal treatment was performed: the most used drugs being carbamazepine, lamotrigine, lacosamide and gabapentinoids. 8 patients underwent invasive procedures (3 microvascular decompression, 2 percutaneous surgeries, and 3 trigger-point blocks).

CONCLUSIONS

18.6% of patients presented at least one status episode. The most administered rescue drugs were first-step analgesia and opioids and the most effective ones seemed to be opioids and antiepileptics. 20% of status required hospitalization and 8 patients required invasive procedures.