title: The choice of therapy in medically intractable trigeminal neuralgia.
abstract: Trigeminal neuralgia stands out as one of the few severe neuropathic pain states for which successful treatment options are available. Up to one-half of patients become refractory to medical therapy over time. At this point, the question of which intervention is appropriate becomes an important issue. A personal series of 150 patients treated between 1988 and 1995 is reviewed. Patients under 65 years and in good general health underwent surgery for microvascular decompression of the trigeminal root; in the remaining 120 patients glycerol was injected percutaneously into the trigeminal cistern. The results in these two patient groups is presented and the rationale of choosing an operative versus a percutaneous procedure is discussed in light of the outcome in this series and in the literature.
authors.affiliation: Department of Neurosurgery, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Z H
authors.initials: ZH
authors.lastname: Rappaport
mesh_terms: D005500:Follow-Up Studies; D005990:Glycerol; D006801:Humans; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods; D010148:Intractable Pain / Q000628:therapy*; D018579:Patient Selection; D012008:Recurrence; D019051:Rhizotomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000628:therapy*
chemical_list: D005990:Glycerol