title: Percutaneous balloon compression for the treatment of trigeminal neuralgia in patients with multiple sclerosis. Analysis of the potentially prognostic factors.
abstract: BACKGROUND
  The role of different procedures for the treatment of drug-resistant trigeminal neuralgia (TN) in patients affected by multiple sclerosis (MS) is under discussion and there are no clear indications in the literature. In particular, the role of percutaneous balloon compression (PBC) has been poorly addressed so far. Moreover, to the best of our knowledge, there are no reports analysing the factors potentially related to the prognosis in these patients. We examined the role of PBC for the treatment of TN in MS patients and investigated the role of some clinical and procedure-related factors in determining the prognosis of these patients.
  
  
  METHODS
  We retrospectively reviewed clinical and outcome data of 21 MS patients submitted to PBC (eight of them had already been treated with different procedures). We analysed the impact of the sex, number of affected trigeminal divisions, pre-operative deficit, previous operations, compression time and balloon shape at the operation, on acute pain relief (APR) by the chi-squared statistic and on pain-free survival (PFS) by the Kaplan-Meier method.
  
  
  RESULTS
  An excellent (BNI I-II)-good (BNI III) outcome was obtained in all patients with a single or repeated procedure. The presence of a single affected trigeminal division (p = 0.042), the absence of previous operations (p = 0.048), the compression time ≤5 min (p = 0.0067) and the pear-like shape of the balloon at the operation (p < 0.05) were associated to higher pain-free survival.
  
  
  CONCLUSIONS
  PBC is a safe and effective technique to treat drug-resistant TN in MS patients. Some clinical and procedure-related factors may play a role in the prognosis of these patients.
authors.affiliation: Institute of Neurosurgery, Catholic University, Rome, Italy. nicolamontanomd@yahoo.it
authors.forename: Nicola
authors.initials: N
authors.lastname: Montano
authors.forename: Fabio
authors.initials: F
authors.lastname: Papacci
authors.forename: Beatrice
authors.initials: B
authors.lastname: Cioni
authors.forename: Rina
authors.initials: R
authors.lastname: Di Bonaventura
authors.forename: Mario
authors.initials: M
authors.lastname: Meglio
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000628:therapy*; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000150:complications* / Q000628:therapy*