What is different about trigeminal neuralgia in multiple sclerosis?
Between 1% and 2% of patients with MS present with symptoms of TN. In patients with a history of MS, TN generally presents bilaterally. TN complaints in MS patients are most common between the ages of 60 and 70 years of age, and in these patients a history of hypertension is correlated with a slightly higher incidence of TN. Unfortunately, TN secondary to MS is extremely difficult to treat, as painful symptoms stem from demyelination rather than vascular compression of the nerve root. Therapies effective in traditional TN are often less effective for this mechanism of action, and treatment should focus on MS prior to TN.
