• Loïc Granzer-Corno, Ria Rana, Bruce D Dick, and Tejas Sankar.
• Division of Neurosurgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
• World Neurosurg. 2024 Nov 20.

AbstractTrigeminal neuralgia (TN) has been described as one of the worst pains known to humankind. However, pain severity in TN has been measured using several different scales, resulting in difficulty comparing illness burden and response to TN surgery across studies. We examined the degree of concordance between standardized scales evaluating pain severity in a cohort of patients undergoing surgery for TN. In this cross-sectional study, we evaluated 39 surgical TN patients with three pain measurement instruments: a Visual Analog Pain Scale (VAS), the Brief Pain Inventory-Facial Pain (BPI-F), and the Barrow Neurological Institute Pain Intensity Score (BNI). Scores were transformed into a 0-10 scale, and grouped into five severity categories (none, mild, moderate, severe, worst). Discordant patients were those classified in different severity categories by at least two pain measurement instruments. Level of agreement was assessed with the intraclass correlation coefficient (ICC). Almost 50% of patients (18/39) had at least one categorical discordance when comparing all three scores. We found 30% discordance between VAS and BPI-F, 33% discordance between BPI-F and BNI, and 35% discordance between VAS and BNI. The highest degree of discordance between BNI and either VAS or BPI-F occurred in patients with moderate pain (BNI IIIb). The degree of agreement across all three scores was moderate (ICC = 0.72). TN patients with residual mild-moderate pain after surgery are often discordantly classified by different pain measurement scales. These findings argue for a more standardized method of reporting port-operative pain outcomes in the TN literature.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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