J Mult Scler Res. 2023; 3(1): 1-8 | DOI: 10.4274/jmsr.galenos.2023.2023-1-1

Association of Trigeminal Neuralgia with Multiple Sclerosis: A Comprehensive Review of Neuropathic Pain Treatment

Chrysoula Petrou¹, Anestakis Doxakis², Marissa A. Barrera³, Polyanthi Konstantinidou^4
1Aristotle University of Thessaloniki, Thessaloniki, Greece
²University of Cyprus Faculty of Medicine, Department of Pathology, Nicosia, Cyprus
³Yeshiva University, Katz School of Science and Health, New York, United States
⁴Forensic Medical Service of Thessaloniki, Laboratory of Pathology, Thessaloniki, Greece

This comprehensive review aimed to evaluate the association between trigeminal neuralgia and multiple sclerosis (MS). Neuropathic pain was analyzed, and trigeminal neuralgia and MS were compared. Pharmacological and surgical treatments for trigeminal neuralgia in patients with MS were explored in detail. The inclusion criteria were as follows: (1) studies of (2) adult participants with trigeminal neuralgia caused by MS, (3) employing pharmacological or surgical interventions and (4) evaluating outcomes related to pain reduction. Carbamazepine or oxcarbazepine is the first-line drug, and lamotrigine, baclofen, gabapentin, and pregabalin are second-line drugs. If the drug cannot control the pain, surgical options must be considered. The surgical procedures include surgical removal of peripheral lesions that are distal to the ganglion, percutaneous gasserian ganglion surgery, stereotactic radiosurgery, and microvascular decompression in the posterior fossa. Owing to the scarcity of data, medical treatment of a patient with MS-related trigeminal neuralgia is challenging. Initiating pharmacological therapy, followed by surgery, is recommended.

Keywords: Multiple sclerosis, neuropathic pain, pharmacological treatment, trigeminal neuralgia

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