Trigeminal Neuralgia: From clinical characteristics to pathophysiological mechanisms

Giulia Di Stefano

nov 2022 · Sapienza Università Editrice

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Trigeminal Neuralgia is a unique neuropathic facial pain condition, characterized by unilateral paroxysmal pain most often described as stabbing or electric shock-like, restricted to the distribution of one or more divisions of the trigeminal nerve territory and triggered by innocuous stimuli. Trigger zones are reported in virtually the totality of patients and represent the hallmark sign of Trigeminal Neuralgia. The development and application of a dedicated software allowed trigger zone overlap profiling of the extraoral and intraoral territories. The analysis of the natural history of Trigeminal Neuralgia showed that the failure of the treatment with first-line drugs (carbamazepine and oxcarbazepine), most of the times, is not due to the inefficacy of the drug, but rather to undesired effects to a level that causes interruption of treatment or a dosage reduction to an insufficient level. These results suggest the opportunity to develop a better tolerated drug.

Winner of the Competition “Prize for PhD Thesis 2020” arranged by Sapienza University Press.

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Giulia Di Stefano, MD, PhD, is a researcher of Sapienza University of Rome, at the Department of Human Neuroscience. In the last 10 years, her research projects focused on the development of new, neurophysiological techniques to test the nociceptive afferents, on the application of neurophysiological and morphometric techniques in the study of the pathophysiological mechanisms of pain and on the investigation of possible biomarkers to predict drug response in patients with neuropathic pain. In 2013, in the framework of a fellowship at the Department of Neuroscience, Physiology and Pharmacology, University College of London, she focused on the trigeminal function, and on the brainstem circuitry of defensive responses in humans. One of the main research themes is the study of the pathophysiological mechanisms of facial pain, with a specific focus on trigeminal neuralgia.