Association of trigeminal neuralgia with multiple sclerosis: Clinical and pathological features

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Abstract
The clinical characteristics of facial pain in patients with trigeminal neuralgia (TN) and associated multiple sclerosis (MS) were studied. Among 900 patients with TN 22 (2.4%) had associated MS. Sixteen patients had typical TN, while 6 had atypical TN. Facial pain commenced at a younger age (P < 0.05) and a significantly higher proportion had bilateral facial pain (P < 0.01) in the group with MS compared to TN patients without MS. In 3 patients TN was the 1st manifestation of MS, in the remainder facial pain occurred on an average of 12 yr after onset of MS. Seventeen patients had associated signs of brain stem involvement. The facial pain was indistinguishable from the pain in patients without brain stem deficits. While sclerotic plaques in the CNS probably are of etiological significance for development of TN neither clinical nor neuropathological findings suggest that this is due to affection of trigeminal nuclei complex in the brain stem.