Percutaneous trigeminal nerve compression for treatment of trigeminal neuralgia: results in 50 patients.
The purpose of this study was to review the results of the treatment of trigeminal neuralgia by percutaneous trigeminal nerve compression in 50 patients during a period of 7.5 years and to review the factors associated with pain recurrence. Mean patient age was 61 years (range, 35-86). Among the patients, 52% had previous destructive peripheral procedures; 24% had first division pain; and 10% had multiple sclerosis. The mean follow-up was 3 years (range, 9 mo to 7.5 yr). Eighty-six percent of the patients were satisfied or very satisfied with their pain relief. Mild numbness persisted in 74%, and one patient thought it was severe. Minor masseter weakness resolved in all patients in a maximum of 1 year. Aseptic meningitis occurred in 3 patients. Minor dysesthesia was seen in 20%. Transient 6th nerve palsy was present in one patient. Anesthesia dolorosa or absence of the corneal reflex did not happen. The recurrence rate was 26% (13/50). The mean time until recurrence was 1.5 years (range, 14 d to 3.5 yr). Sixty-two percent (8/13) of patients with recurrence required a subsequent compression. When another compression was done, four of eight had recurrent pain once again. Three of these four patients had undergone two to eight previous destructive procedures. Overall, 8 of 13 patients with recurrence had undergone previous destructive procedures. Early recurrence (in < 1 week) or failure to relieve pain occurred in 8% (4/50) of patients. Half of those with early failure had a subsequent compression. After compression, 70% of patients with recurrence did have numbness.(ABSTRACT TRUNCATED AT 250 WORDS)
Brown
J A
JA
Department of Neurological Surgery, Medical College of Ohio, Toledo.
McDaniel
M D
MD
Weaver
M T
MT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care; D011183:Postoperative Complications; D011859:Radiography; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome; D014276:Trigeminal Nerve; D014277:Trigeminal Neuralgia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*