Stereotactic trigeminal nucleotomy for dysesthetic facial pain.
Trigeminal nucleotomy is a relatively simple, straightforward stereotactic procedure, acting at the deafferentation site, i.e., at the nucleus caudalis. Patients were operated on in a seated position, by a posterior suboccipital approach. Out of a series of 196 patients, 143 underwent trigeminal nucleotomy for deafferentation. Clinical diagnoses were 52 cases of postherpetic pain dysesthesia, 35 of anesthesia dolorosa, 46 of dysesthetic state with superimposed tic-like sequelae of trigeminal surgery performed elsewhere and 9 of posttraumatic neuropathy. Abolition of allodynia or marked reduction in, or disappearance of deep background pain was achieved in 72.0% of the cases overall. Results are analyzed for each clinical category. There were no side effects of any kind. Follow-up ranged from 4 to 17 years. This seems to be the procedure of choice for deafferentation facial pain.
Department of Neurosurgery, University of Buenos Aires, Argentina.
F
F
Piedimonte
J R
JR
Schvarcz
D003714:Denervation; D005157:Facial Pain / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D013238:Stereotaxic Techniques; D016896:Treatment Outcome; D014275:Trigeminal Caudal Nucleus / Q000473:pathology / Q000601:surgery*