[Operative treatment of trigeminal neuralgia].
METHODS
Nowadays the theory of microvascular compression of the root entry zone of trigeminal nerve in case of trigeminal neuralgia is widely accepted. Pathological contacts between a-beta fibers and c-fibers are believed to be caused by an arterial compression in the root entry zone. It is these ephaptic contacts that have led to a logical therapeutic sequence of treatment by means of membrane stabilising agents like anticonvulsant drugs as carbamazepine, nonablative - and, in view of the pathophysiological concept, causal - surgery in form of microvascular decompression described by Jannetta and ablative operative methods, which are restricted to certain well-defined indications.
Other and additional surgical procedures are of use only in cases of atypical facial pain or with therapy non-responders. Methods like Caudalis-DREZ-Lesion and specific techniques such as cervical superior ganglion infiltration with opioids are worth being mentioned.
Görge
H H
HH
Neurochirurgische Klinik, Gesundheitszentrum Evangelisches Stift St. Martin, Koblenz. hhgoerge@gzstift.de
D019299:Decompression, Surgical; D004564:Electrocoagulation; D006801:Humans; D008866:Microsurgery; D013126:Spinal Nerve Roots / Q000601:surgery; D012668:Trigeminal Ganglion / Q000601:surgery; D014276:Trigeminal Nerve / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000209:etiology / Q000601:surgery*