Background: Trigeminal neuralgia (TN) is a severe neuropathic unilateral facial pain affecting about 30% percent of the world population. Neuropathic pains are considered to be associated with multiple sclerosis (MS).Multiple sclerosis is a chronic inflammatory condition causing demyelination and degeneration of axons in central nervous system.
Objective: The objective of the study is to determine role of Magnetic Resonance Imaging to find association between trigeminal neuralgia and multiple sclerosis.
Methods: The prospective cohort study was conducted for six months in Radiology Department of Hayatabad Medical Complex, Peshawar from September 2020 to February 2021. Initially 250 patients were screened for multiple sclerosis. The study recruited a total of 35 patients of MS visited neuroradiology department, out of which 26 patients were enrolled in the study. The participants with age of 18 years and onward of both genders with definitive symptoms of TN with MS that is having unilateral TN pain (that is sharp shooting electric pulse like) lasting for up-to 2minutes precipitated with an environmental stimulus were included in the study. The patients (n=6) with bilateral MS with TN and cognitive disturbances (n=3) were excluded from the study.
Results: The study recruited a total of 26 participants with MS related TN. The clinical examination didn’t show any difference between the three groups with the p-value less than 0.001. Age at the onset of MS was younger in patients with MS related sensory disturbances compared to other two groups, with p-value less than 0.05. The frequency of the affected side was different in all three groups with the p-value less than 0.05 as tested by Fischer exact test. Trigeminal reflex tests done for different components such as R1 and SP1 showed longer latency periods for the affected side after stimulation and unaffected side after stimulation with the mean of 14.2± 4.4 and 15.3±3.2, 16.3±4.2 and 17.4±5.2ms and p-value less than 0.001 as shown by Wilcoxon test.
Conclusion: The study showed significant association between trigeminal neuralgia and multiple sclerosis with the greater efficacy of using MRI as imaging technique to find this association.
Keywords: Multiple sclerosis, Magnetic Resonance Imaging, Trigeminal neuralgia