This study aims to explore demographic characteristics, healthcare utilization, and potential predictors of Multiple Sclerosis (MS) development in patients with Trigeminal Neuralgia (TN) in the state of Florida.

TN is a neuropathic pain disorder characterized by short, severe episodes of facial pain that significantly impact quality of life. Although TN occurs in approximately 3.4% of people with MS, limited research has compared the clinical profiles and outcomes of patients with TN alone, MS alone, and those with both conditions.

This retrospective cohort study utilized the OneFlorida Data Trust (2012-2024) to analyze patients (ages 0-89) diagnosed with ‘trigeminal neuralgia’ (ICD10: G50; ICD9: 350.1) and ‘multiple sclerosis’ (ICD10: G35; ICD9: 340). 

We identified 32,814 MS patients, 14,755 TN patients, and 897 with both. TN was present in 2.73% of MS patients. Among those with both conditions, 79.15% were female, compared to 74.93% in MS-only and 69.62% in TN-only patients. Age at TN diagnosis was younger in patients in MS-TN patients (53.2 years) compared to TN-only (57.7 years). In 26.09% of patients with both conditions, TN preceded MS by an average of 1.6 years. Overall, TN was present at the time of MS diagnosis in 1.23% of all MS patients. Patients with TN diagnosed before MS had the highest healthcare utilization, averaging 45.3 emergency visits compared to 13 in those diagnosed with TN after MS. Hospitalization was higher in MS-TN patients (17.95%) compared to TN-only (9.5%). MS-TN patients were more likely to undergo balloon compression (2.56% vs. 0.54%) and gamma knife procedures (3.23% vs. 2.38%), but less likely to receive radiofrequency ablation (0.55% vs. 0.94%) or microvascular decompression (3.79% vs. 6.77%).

MS and TN comorbidity leads to increased healthcare utilization and surgical interventions. Clinicians should be mindful that TN may be a presenting syndrome of MS allowing for earlier identification and directed treatment.