Abstract
OBJECTIVE: Trigeminal neuralgia (TN) is a rare, debilitating craniofacial pain disorder that is uncommon in children, representing 1%-1.5% of cases. While adult TN is well-documented, data on pediatric presentations, treatment patterns, and healthcare disparities remain limited. This study characterizes demographic trends, procedural interventions, and inpatient cost trends for pediatric patients with TN using a national dataset.
METHODS: The authors conducted a retrospective cohort study using the National Inpatient Sample from 2011 to 2020 to identify patients with TN younger than 18 years. Demographics, insurance status, geographic region, and procedural interventions were extracted. Outcomes included procedure rates, discharge disposition, and total hospital charges. The chi-square test, t-test, and an ANOVA were used to assess the associations between demographics, interventions, and costs.
RESULTS: A total of 214 pediatric TN admissions were identified over the 10-year period. The mean patient age was 13.5 (SD 3.75) years, and 66.8% were female. A majority of patients were White (71.4%) and privately insured (63.4%). Overall, 55 patients (25.7%) underwent procedures, most commonly anesthesia application to the cranial nerve and nerve decompression. Patients receiving procedures were significantly older (14.3 vs 13.2 years, p = 0.012), more likely to be privately insured (p = 0.043), and more frequently from the West South-Central region (p < 0.001). No significant differences were observed based on race or income quartile. Total inpatient charges over the decade exceeded $4.5 million US, with most patients discharged home posttreatment.
CONCLUSIONS: This study represents the largest known national cohort of pediatric patients with TN. While most patients were managed nonoperatively, a notable portion underwent procedural interventions, particularly older children and those with private insurance. Geographic disparities were evident, warranting further investigation into referral patterns and healthcare access. These findings underscore the need for broader, multicenter efforts to optimize diagnosis and equitable treatment for pediatric TN.