Multiple Sclerosis and Trigeminal Neuralgia: A Well-Noted Association with Unknown Occurrence as a Presenting Symptom: Our Experience in Multi Centric Study

Objective: The association between trigeminal neuralgia (TN) and multiple sclerosis (MS) is well established. In many cases series the frequency of TN is reported in patients with MS but information regarding the frequency of trigeminal pain as a symptom of disease onset is lacking. We present a multi centric analysis of SM-patients affected by TN where we investigated the onset of symptomatology and a current literature analysis. Patients and Methods: We prospectively acquired clinical and radiological information of patients with MS and with TN that were visited at our clinics in two different departments. A pertinent literature review was carried out as well. We investigated the prevalence of TN in patients with MS and we noted whether facial pain was the symptom of MS onset. Results: A total of 718 patients with multiple sclerosis were analyzed, of which 63 presented TN. The neuropathic facial pain was the presenting symptom of MS in 3 patients, that constituted 0.4% of cases. The results reported in the literature confirm a frequency of 0.4-1% of the cases in which the first symptom of MS is TN and are like those observed in our study. Conclusions: Is important to investigate the rate of debut of TN in SM patients to set up the correct diagnostic and therapeutic program. Among the different types of neuropathic pain, TN in MS patients are a difficult to treat with a relevant impact on the quality of life. TN constitutes a clinical picture frequently associated with the MS. Nevertheless, TN as a clinical manifestation of the onset of MS is a rare occurrence and is just noted that is rarely the first symptom of disease.