Multiple cranial nerve palsies following radiofrequency ablation for trigeminal neuralgia.
A 33-year-old man developed diffuse subarachnoid haemorrhage following attempted radiofrequency ablation for trigeminal neuralgia. Over the next 2 weeks, he progressively developed multiple bilateral cranial nerve palsies, bilateral cerebellar signs, hypotonia of all four limbs and diminished vision in both eyes. A visual-evoked potential study revealed anterior visual pathway defect. A possibility of demyelination was considered and he was treated with corticosteroids. His neurological deficits improved gradually over the next 4 months. He later underwent microvascular decompression uneventfully with good pain relief. This complication has not been reported earlier and needs to be kept in mind while performing radiofrequency ablation.
Madhusudan Reddy
K R
KR
Departments of Neuroanaesthesia, National Institute of Mental Health and Neurosciences, Bangalore, India.
Arivazhagan
A
A
Chandramouli
B A
BA
Umamaheswara Rao
G S
GS
D000328:Adult; D017115:Catheter Ablation / Q000009:adverse effects*; D003389:Cranial Nerve Diseases / Q000209:etiology*; D003711:Demyelinating Diseases / Q000188:drug therapy / Q000209:etiology*; D005074:Evoked Potentials, Visual / Q000502:physiology; D006801:Humans; D008297:Male; D013345:Subarachnoid Hemorrhage / Q000209:etiology*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery; D014786:Vision Disorders / Q000209:etiology*