Discussion

Introduction: Trigeminal neuralgia (TN) is an uncommon disorder that leads to debilitating pain and interference with daily life. Though TN is often considered to be secondary to neurovascular compression, there is sparse literature identifying the underlying etiology and risk factors of TN and other neurovascular compression syndromes. In this study, we aim to examine risk factors for the development of TN by utilizing the National Inpatient Sample (NIS).

Methods: A query of the NIS dataset from 2016-2019 was performed to identify all patients diagnosed with TN (ICD-10 G50.0). Demographics and comorbidities were identified. Comorbidities were classified based on the Charlson Comorbidity Index (CCI) mapping of ICD-10 codes. Patients diagnosed with TN were matched to non-TN patients using a 1:1 propensity match based on demographics, hospital characteristics, and CCI score. Multivariable regression was performed to identify factors associated with TN and calculate adjusted odds ratios (OR).

Results: The final cohort consisted of 272,690 patients, of whom 136,345 (50.0%) had TN. After propensity matching, patients were at increased risk of developing TN if they had multiple sclerosis, previous history of meningitis, other neurovascular compression syndromes, epilepsy, or hyperlipidemia (p < 0.01). After stratifying risk factors by odds ratios greater than 2, the risk factors with the largest effect included a history of meningitis (OR: 3.52, p = 0.004), multiple sclerosis (OR: 12.62, p < 0.001), glossopharyngeal neuralgia (OR: 77.15, p < 0.001), and hemifacial spasm (OR: 28.14, p < 0.001).

Conclusion : In this 4-year nationwide retrospective study, meningitis, multiple sclerosis, and other neurovascular compression syndromes were demonstrated to be significant risk factors for the development of trigeminal neuralgia. This study is the first to identify meningitis as a potential risk factor for TN. Further prospective studies are warranted to better elucidate these risk factors.