A Potential Role for Steroids in Acute Pain Management in Patients with Trigeminal Neuralgia

-OBJECTIVE: Effective therapies for acute pain manage-ment in trigeminal neuralgia (TN) are limited. We aimed to investigate the role of steroids in TN patients experiencing acute pain flares. -METHODS: We retrospectively reviewed patients pre-senting to the emergency department of a tertiary care institution between 2014 and 2020 for acute TN pain flares. Patients were divided into those who received steroids versus those who did not. Presenting characteristics, admission and surgical intervention rates, Barrow Neuro-logical Institute pain scores, pain recurrence rates, and surgical intervention within 6 months of discharge were obtained for each patient. -RESULTS: Our cohort comprised 151 patients, of whom 40 (26.5%) received steroids before admission and/or discharge. These patients were less likely to undergo surgical intervention to treat acute pain (P = 0.023). Spe-cifically, patients receiving steroids were less likely to -ndergo combined glycerin and radiofrequency rhizotomy compared with 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 Barrow Neurological Institute pain score on discharge compared with the no steroids group (P = 0.013). Patients receiving steroids for acute pain manage-ment were less likely to undergo surgical intervention within 6 months of discharge than patients who did not receive steroids (P = 0.033).-CONCLUSIONS: Steroid administration in patients with acute TN pain flares 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 TN pain management.

Automated summary

Steroid administration in patients with acute TN pain flares may reduce the likelihood of surgical intervention both during admission and within 6 months of discharge.