title: Descending trigeminal tractotomy for trigeminal neuralgia after surgical failure.
abstract: Percutaneous rhizotomy, microvascular decompression or rhizotomy by suboccipital craniotomy often cures medically untreatable trigeminal neuralgia with an acceptable complication rate. However, pain involving the same trigeminal distribution persists in a few patients despite both rhizotomies. For 7 patients with such surgically 'failed' trigeminal neuralgia, we performed descending trigeminal tractotomy. In all patients, neuralgia ceased immediately postoperatively and has not recurred during 9 months to 15 years follow-up. Descending trigeminal tractotomy provides a satisfactory solution to this relatively rare but paroxysmal pain syndrome.
authors.affiliation: Department of Neurological Surgery, School of Medicine, University of California, San Francisco.
authors.forename: M
authors.initials: M
authors.lastname: Morita
authors.forename: Y
authors.initials: Y
authors.lastname: Hosobuchi
mesh_terms: D000328:Adult; D003399:Craniotomy; D005071:Evoked Potentials; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D017211:Treatment Failure; D014276:Trigeminal Nerve / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000503:physiopathology / Q000601:surgery*