Análise do fenótipo clínico de pacientes com neuralgia do trigêmeo atendidos no Ambulatório de Dor Orofacial do Hospital Universitário Pedro Ernesto

Abstract

Due to the multidimensional behavior of pain, knowledge of the factors that may contribute to the treatment response is essential for better functional results. The study of the clinical phenotype of the search identifies unique characteristics in each individual that are related and commented on for the maintenance of the painful process. Objectives: The aim of this study was to examine the clinical features of patients with trigeminal neuralgia, focusing on the following areas: pain quality, psychosocial aspects (anxiety, depression, and catastrophizing), and sleep quality. Materials and methods: In this observational study, we evaluated patients diagnosed with TN according to the International Classification of Orofacial Pain. The study took place at the Orofacial Pain Outpatient Clinic of Hospital Universitario Pedro Ernesto between January 2020 and August 2022. We used the following assessments: painDETECT (to evaluate neuropathic pain), Hospital Anxiety and Depression Scale (HAD), Pain Catastrophizing Scale (PCS), and Sleep Quality Index (PQSI). Descriptive analysis and statistical tests were conducted on the collected data. Results: A total of 38 patients (26 women) with an average age of 64.4 ± 8 years were included in the study. Despite the use of one or more medications for TN treatment, 50% of the patients experienced moderate to severe pain. Catastrophizing scores (PCS >20) were observed in 73.7% of the patients, while 28.9% had anxiety (HAD_a≥9), 34.2% had depression (HAD_d≥9), and 86.8% had poor sleep quality (PSQI≥ 6). The average pain level was found to be associated with depression (p=0.01), anxiety (p=0.04), and catastrophizing (p=0.03). Additionally, catastrophizing was linked to the neuropathic characteristics of pain. Conclusion: Our findings suggest that patients with trigeminal neuralgia have high levels of catastrophizing with a significant correlation between catastrophizing and anxiety, indicating the need for a multidisciplinary approach for better pain control.