Effects of Multi-Modal Approach on Vibration Perception Threshold (VPT) in Trigeminal Neuralgia Using Neurothesiometer

Abstract

This case study describes a 50 years old woman diagnosed as a case of trigeminal neuralgia with no remarkable findings on CT scan. She presented with clinical signs and symptoms of trigeminal neuralgia and depression. The objective of this study was to determine the effect of multi-modal approach on pain, vibration perception threshold and depression. She was assessed for pain on numerical pain rating, vibration perception threshold from ophthalmic, maxillary and mandibular branches of trigeminal nerve on neurothesiometer and depression on beck’s inventory of depression. Study was conducted from June to September, 2022 at Zubaida Khanum Medical Center Gujar Khan, THQ Gujar Khan, THQ Sohawa, Pakistan. Detailed history was taken using an 18-item questionnaire, designed by the Pain Panel of the European Academy of Neurology (EAN). Patient had 15 sessions based on a multi-modal approach which included Medications, Physical therapy and Cognitive behavioral therapy. Data was collected before and after the intervention. Vibration Perception Threshold not also improved on the affected side (p-value 0.033) but also on the unaffected side (0.038). Pain decreased significantly (≥30%) as well as symptoms of burning sensation, numbness, muscular pain, difficulty in chewing and tinnitus were also relieved. Depression was decreased from a score of 29 to 12 on Beck’s Inventory of depression.