Clinical Analysis of Misdiagnosis of Trigeminal Neuralgia

PANG Jinlei; SUN Haiyan; GUO Xiangfei; HUO Yansong; HE Mingwei

doi:10.3969/j.issn.1002-3429.2024.20.001

Abstract：Objective To analyze the clinical characteristics and causes of misdiagnosis of trigeminal neuralgia(TN),so as to reduce misdiagnosis and improve diagnostic accuracy.Methods The clinical data of 3 misdiagnosed patients with TN from January 2021 to December 2022 were retrospectively analyzed.Results A female patient suffered from intermit-tent severe pain on the right side of the face for six months.The patient was initially diagnosed as pulpitis,and the patient re-ceived several dental treatments,which,however,failed.After collection of detailed medical history and neurological exami-nation,it was found that the pain was electric shock,and combined with the neurological examination and imaging examination results,it was confirmed as TN.A male patient presented with left facial pain with headache for 2 months.The initial diagno-sis of migraine was confirmed as TN after Nonsteroidal anti-inflammatory drugs and Antidepressants failed to respond to treat-ment.A female patient presented with recurrent electric shock pain on the left side of her face.The initial diagnosis was hemi-facial spasm,followed by local Botulinum toxin injection and other related treatments,but the effect was not obvious;the diag-nosis was later confirmed as TN by neurologic and imaging examination.The duration of misdiagnosis was 6,2,and 3 months,respectively.All patients were treated with Carbamazepine after diagnosis and the prognosis was good.Conclusion The early misdiagnosis rate of TN is high.It is necessary to improve the understanding of clinicians,strengthen the collec-tion of medical history,and combine imaging and other medical technical examinations when necessary to improve the diagnos-tic accuracy.