title: Comparative evaluation of percutaneous retrogasserian glycerol rhizolysis and radiofrequency thermocoagulation techniques in the management of trigeminal neuralgia.
abstract: BACKGROUND
  Among the percutaneous procedures for the treatment of trigeminal neuralgia, percutaneous anhydrous glycerol rhizolysis (PRGR) and radiofrequency (RF) ablation of trigeminal neuralgia have stood the test of time.
  
  
  OBJECTIVE
  A prospective study was conducted to compare PRGR and RF ablation techniques in patients with trigeminal neuralgia in terms of (1) efficacy of pain relief, (2) duration of pain relief and (3) side effects.
  
  
  METHODS
  All patients presenting to our pain clinic for the first time for the treatment of trigeminal neuralgia were enrolled to receive either PRGR or RF ablation; the treatment was chosen by the patient. Demographic data, magnetic resonance imaging scan, relevant medical disease, amount of anhydrous glycerol, lesion temperature, and total duration of RF were noted. The presence or absence of cerebrospinal fluid egress, immediate pain relief, duration of pain-free period, need for repeat injection or additional peripheral nerve block, and recurrence of pain were also noted. The degree of pain relief was recorded every 3 months. Any complications during the procedure and side effects were also recorded.
  
  
  RESULTS
  Seventy-nine patients underwent either PRGR (n = 40) or RF thermocoagulation (n = 39). A total of 23 patients (58.9%) in the PRGR group and 33 patients (84.6%) in the RF group experienced excellent pain relief. The mean duration of excellent pain relief in the PRGR and RF groups was comparable. By the end of the study period, 39.1% patients in the PRGR group and 51.5% patients in the RF group experienced recurrence of pain.
  
  
  CONCLUSIONS
  Both PRGR and RF techniques can achieve acceptable pain relief with minimal side effects.
authors.affiliation: Department of Neuroanaesthesiology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bidkar Prasanna
authors.initials: BP
authors.lastname: Udupi
authors.forename: Rajendra S
authors.initials: RS
authors.lastname: Chouhan
authors.forename: Hari H
authors.initials: HH
authors.lastname: Dash
authors.forename: Parmod K
authors.initials: PK
authors.lastname: Bithal
authors.forename: Hemanshu
authors.initials: H
authors.lastname: Prabhakar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005990:Glycerol / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010146:Pain / Q000209:etiology / Q000601:surgery; D019051:Rhizotomy / Q000379:methods*; D012997:Solvents / Q000627:therapeutic use; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000150:complications / Q000601:surgery*
chemical_list: D012997:Solvents; D005990:Glycerol