Symptomatic Trigeminal Neuralgia Attributed to Multiple Sclerosis - a Prospective Study in 60 Patients

NCT ID: NCT04371575

Last Updated: 2020-05-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-09-01

Study Completion Date

2019-12-31

Brief Summary

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Clinical characteristics, neuroanatomical findings and efficacy of medical and surgical treatment of symptomatic trigeminal neuralgia - a systematic prospective study of 60 consecutive patients

Detailed Description

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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.

Conditions

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Trigeminal Neuralgia Multiple Sclerosis Pain, Neuropathic

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Carbamazepine

There is no actual intervention as the study is observational. First choice tratment is Carbamzepine and Oxcarbazepine. In medically refractory patients, first choice surgery is microvascular decompression

Intervention Type DRUG

Other Intervention Names

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Oxcarbazepine

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of secondary trigeminal neuralgia attributed to multiple sclerosis
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Stine Maarbjerg, MD PhD

OTHER

Sponsor Role lead

Responsible Party

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Stine Maarbjerg, MD PhD

Post doc

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Lars Bendtsen, Dr Med Sci

Role: PRINCIPAL_INVESTIGATOR

Danish Headache Center

References

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Noory N, Smilkov EA, Frederiksen JL, Heinskou TB, Andersen ASS, Bendtsen L, Maarbjerg S. Neurovascular contact plays no role in trigeminal neuralgia secondary to multiple sclerosis. Cephalalgia. 2021 Apr;41(5):593-603. doi: 10.1177/0333102420974356. Epub 2020 Nov 28.

Reference Type DERIVED
PMID: 33249870 (View on PubMed)

Other Identifiers

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010919

Identifier Type: -

Identifier Source: org_study_id

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