Multimodality treatment of trigeminal neuralgia.
Most trigeminal neuralgia (TN) studies focus on a single strategy, microvascular decompression (MVD) or percutaneous rhizotomy (PR). We use a multimodality approach to TN. We perform MVD on patients younger than 70 years and PR on older patients or those where MVD has failed. We performed a chart review of the procedures for TN over the past 3 years and used a questionnaire for long-term follow-up. The questionnaire asked patients to rate their pre- and postoperative pain, outcome, and medication changes. Seventy-four procedures (40 MVDs and 34 PRs) were performed on 67 patients. Twenty patients had undergone previous procedures. 93% of the patients had significant initial pain relief. Over a 1.2-year mean follow-up, 51% of the patients had complete pain relief while 27% had a substantial improvement. There were no deaths and 5 complications. Our results suggest that a multimodality approach to TN yields excellent results with minimal complications.
Amirnovin
Ramin
R
Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Neimat
Joseph S
JS
Roberts
Jane A
JA
Eskandar
Emad N
EN
D000367:Age Factors; D000465:Algorithms; D003131:Combined Modality Therapy; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D019051:Rhizotomy / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*