Low saturated fat diet is effective in trigeminal neuralgia

Objective: To determine the effectiveness of low saturated fat diet (LSFD) in patients with trigeminal neuralgia (TN). Design: 1) Internet forum where patients could request a 10 page LSFD plan, and 2) Follow-up assessment done by a retrospective 20-item questionnaire. Duration of treatment—2 months to 13 years. Pain rated on a Visual Analogue Scale and reported as typical, atypical, or both, defining typical TN as intermittent quick jolts/stabbing pain and atypical TN as continuous never ending discomfort. Setting: General community. Patients: 55 unselected patients, most with unilateral, severe and daily symptoms in V2 and V3 distribution for a mean duration of 8 years and on medications. 84% had pain level 9-10 before treatment, 89% had daily attacks and 31% had undergone surgical procedures. Intervention: LSFD for 2 months-13 years (mean 20 months). Main outcome measure: VAS score and medication use before and after LSFD treatment. Results: Reported SF content was 3-25 gm. With treatment 96% typical TN (p < 0.0001) and 71% atypical TN (p < 0.002) improved to level 0%-2. 9% improved in less than a week, 47% in 1-2 weeks and 44% in 3-4 weeks. 66% rated their compliance with diet as excellent and 27% as good. There were no side effects except weight loss. 72% of those on medications reduced or discontinued them. All patients with post-surgical residual severe typical TN also improved (p < 0.0001). Conclusions: LSFD is effective in TN with high compliance, few adverse effects and may result in reduction/ elimination of medications even in most severe cases.