Multiple Sclerosis Clinical Trial
Official title:
Symptomatic Trigeminal Neuralgia Attributed to Multiple Sclerosis - Clinical Characteristics, Neuroanatomical Abnormalities and Treatment Efficacy
Clinical characteristics, neuroanatomical findings and efficacy of medical and surgical treatment of symptomatic trigeminal neuralgia - a systematic prospective study of 60 consecutive patients
Background Among patients with TN, approximately 15% has secondary TN caused by another
underlying condition such as multiple sclerosis or a tumor. Studies of classical TN patients
have shown a strong association between a severe NVC of the trigeminal nerve and the painful
side. This association has been less investigated in STN.
There are no previous systemic and prospective studies of the underlying causes,
characteristics and treatment response of patients with STN. Most existing studies on STN
have various methodological drawbacks as inclusion was not prospective, diagnosis was not
consistent with international guidelines, imaging techniques were not adequately advanced at
the time of publication and evaluation of treatment efficacy was not performed by evaluators
independent of the neurosurgeon.
Aims
1) To describe the clinical characteristics, the neuroanatomical findings using 3.0 Tesla
MRI, and the efficacy of medical and surgical treatment in STN
Hypotheses
1. In STN, there is a correlation between demylinating brainstem plaques and presence and
degree of neurovascular contact of the trigeminal nerve ipsilateral to the painful side
2. The efficacy of medical and surgical treatment of STN is comparable to the efficacy in
patients with classical trigeminal neuralgia
Power calculations Sample size depends on the number of patients in the inclusion period. The
estimated number of included patients is at least 60 patients.
Methods Data have been collected prospectively since 2012 based on semi-structured interview
forms completed at out-patient visits at the Danish Headache Center. The efficacy of medical
and surgical treatment was also documented prospectively by structured interviews. Efficacy
of surgical treatment was evaluated by independent assessors.
All patients had a 3.0 Tesla MRI with a special protocol adapted for the trigeminal nerve and
the brainstem.
Ethical considerations The treatment of patients with STN will not differ from the usual
treatment and decision-taking.
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