Characteristics of Patients With Trigeminal Neuralgia Referred to the Indonesian National Brain Center Neurosurgery Clinic

Abstract

Trigeminal neuralgia (TN) is a debilitating neuropathic pain involving the fifth cranial nerve. There has been no study investigating the clinical and socioeconomical characteristics of patients with TN in Indonesia. A total of 100 patients were included in this study. Symptoms indicating a later stage of the illness, namely, involvement of all the trigeminal nerve branches, numbness, and concomitant persistent pain, were the common presentations found in our cohort. Only one TN diagnosis was made by a general practitioner (GP). None were immediately referred to a neurosurgeon following their diagnosis. Access to our clinic took as long as 4.7 ± 5.1 years (mean ± SD) from the onset. Older age was a significant predictor of an increased likelihood of not knowing their illness upon the referral (21.9%, p = 0.008). Upon their first presentation, 25.5% of patients had experienced drug-related side effects due to prolonged medication. Only 50% of patients were compensated by the universal health coverage (UHC) system. Seven patients spent ≥ 50 million rupiahs and eight patients had already lost their jobs. In conclusion, early contact with a neurosurgeon contributes to better management of TN, both for the patients and healthcare system in Indonesia. A refined understanding of TN nature is still needed in this country.

Systematic review on the frequency of occurrence in nerve branches and the side of the face involved in trigeminal neuralgia and its clinical implication

“…Based on the reviewed literature, TN is diagnosed based on clinical grounds; therefore, a thorough clinical history, with special attention to the patient's description of symptoms, is the first essential step in the diagnosis process ( 31 ). The majority of research studies that have been published indicated that the ocular division (V1) was less frequently exhibited and that the mandibular division (V3) was most frequently implicated, followed by the maxillary division ( 10 , 18 , 19 , 23 , 32 , 33 ). Furthermore, this systematic review revealed that the right side of the face is more frequently affected than the left side in 90% of the included articles, and this could be due to the fact that the foramen rotundum and foramen ovale on the right are narrower than those on the left ( 32 ).…”

The start-up of a neurosurgical service in an East Indonesian archipelagic province: The first 2-year experience of North Maluku Database in Neurosurgery (NOMADEN)

“…reported the characteristics of 100 surgically-managed trigeminal patients from 2014 to 2021 in a national referral hospital in Jakarta. [ 23 ] Wahyuhadi et al . reported a register of 1540 patients who underwent surgery for brain tumors during 2012–2018 in a single general academic hospital in Surabaya, East Java.…”

“…[30] Prasetya et al reported the characteristics of 100 surgically-managed trigeminal patients from 2014 to 2021 in a national referral hospital in Jakarta. [23] Wahyuhadi et al reported a register of 1540 patients who underwent surgery for brain tumors during 2012-2018 in a single general academic hospital in Surabaya, East Java. [31] Tandian et al made a specific report on the characteristics, management, and outcome of 44 medulloblastoma patients surgically managed from 2011 to 2018 in one national referral hospital in Jakarta.…”