A potential role for steroids in acute pain management in patients with trigeminal neuralgia. World neurosurgery Xu, R., Nair, S. K., Shah, P. P., Kannapadi, N., Materi, J., Alomari, S., Kim, T., Kalluri, A., Xia, Y., So, R. J., Lim, M., Bettegowda, C. 2022


OBJECTIVES: Effective therapies for acute pain management in trigeminal neuralgia (TN) are limited. Here, we investigate the role of steroids in TN patients experiencing acute pain flares.METHODS: We retrospectively reviewed patients presenting to the emergency room of a tertiary care institution between 2014-2020 for acute trigeminal neuralgia pain flares. Patients were dichotomized into those who received steroids versus those who did not. Presenting characteristics, admission and surgical intervention rates, Barrow Neurological Institute (BNI) pain scores, pain recurrence rates, and surgical intervention within 6 months of discharge were obtained for each patient.RESULTS: Our cohort consisted of 151 patients, with 40 (26.5%) receiving steroids prior to admission and/or discharge. These patients were less likely to undergo surgical intervention to treat their acute pain, p=0.023. Specifically, patients receiving steroids were less likely to undergo combined glycerin and radiofrequency rhizotomy compared to patients not receiving steroids, p=0.012. Frequency and dosage of opioid administration did not differ between groups. The steroids group demonstrated a lower average BNI pain score on discharge compared to the no steroids group, p=0.013. Patients receiving steroids for acute pain management were less likely to undergo surgical intervention within 6 months of discharge than those who did not receive steroids, p=0.033.CONCLUSIONS: Steroid administration in these cases may reduce the likelihood of surgical intervention both during admission and within 6 months of discharge. Future prospective studies should examine the efficacy of steroids as an adjunctive medication in acute trigeminal neuralgia pain management.

View details for DOI 10.1016/j.wneu.2022.09.025

View details for PubMedID 36113711