Epidemiology of the Trigeminal Neuralgia in adults from Uberlandia, including the nerve branch and the most property treatment

Abstract

Introduction: Trigeminal neuralgia (TN) is a pathology with pathognomonic aspects, including characterized by episodes of paroxysmal and excruciating pain, similar to electric shock, debilitating, triggered by touching the skin area of ​​the face of the nerve ending of the nerve, called zone of kitten. The pains are intense and of short duration, with variable intervals. The diagnosis is eminently clinical and its treatment can be complex. TN can be idiopathic or caused by anatomical changes that can cause compression in a branch of the trigeminal nerve, leading to focal demyelination of the nerve sheath, which through axonal apposition generates spontaneous impulses in adjacent fibers (Love; Coakham, 2001).
Objective: To verify the incidence of trigeminal neuralgia in adult patients in the Specific Care Program for Stomatological Diseases of the Federal University of Uberlândia (UFU), relating age, gender, branch of the trigeminal nerve and form of treatment.
Methodology: Two hundred medical records of adult patients from the UFU Specific Care Program for Stomatological Diseases were observed. The frequency of each variable, such as the branch of the trigeminal nerve affected, age and sex of the patient, side of the face and treatment, was evaluated through statistical analysis, chi-square test. The research was conducted in accordance with the protocol approved by the Ethics Committee for Research with Human Beings (CEP-UFU), under registration number 2,844,148.

Results and discussion: The results revealed that of the total sample of 200 patients, 20 had a diagnosis of TN (10%), 14 women (70%) and 6 men (30%), 7 being the mandibular ramus affected (35%) , 12 for the maxillary branch (60%) and 1 for the ophthalmic branch (5%). The right side was the most affected, 14 cases (70%), compared to the left, 6 (30%), a fact that coincides with the literature (Di Stefano et al., 2018). Of the patients diagnosed with TN, only 1 was younger than 40 years old, being 38 years old, which is in agreement with the literature that indicates a higher incidence of this neuropathy in women from 40 years old (Quesada et al., 2005).

The Chi-square test showed no correlation between age (P = 0.215) and gender (P = 0.255) with NT. The most used treatment was medication, with carbamazepine being the most prevalent (75%), followed by gabapentin (15%), cytoneurim (10%) and capsaicin (10%). These results agree with the literature that points to carbamazepine or oxycarbamazepine as first choice drugs for the treatment of TN (Bendtsen et al., 2020). Treatment with laser therapy was also presented by 10% of the patients studied.

Conclusion: Based on our results, we conclude that trigeminal neuralgia is more prevalent in women over the fourth decade of life, unilateral, with the maxillary branch being more affected on the right side. Drug treatment is the most prevalent, with carbamazepine being the drug of first choice, which may or may not be associated with laser therapy. These aspects become a clinical tool to help health professionals to develop a protocol for approaching patients with trigeminal neuralgia, with knowledge about the anatomy of the nerve and the pathology of this neuropathy being essential for the initial approach, diagnosis and treatment.