Operative treatment of trigeminal neuralgia: review of current techniques

Prabhakar

Journal of Neurosciences in Rural Practice

2011

Background:Trigeminal neuralgia typically involves nerves supplying teeth, jaws and face of older females. Though the etiology is usually obscure, different treatment modalities have been tried for it viz. medicinal treatment, injection alcohol, peripheral neurectomy, rhizotomy, and microvascular decompression etc. Transcutaneous electric nerve stimulation (TENS) is an emerging and promising option for management of such patients.Aims and Design:The present study was designed with an aim to study the efficacy of TENS in management of trigeminal neuralgia.Materials and Methods:The study was conducted on 30 patients of trigeminal neuralgia confirmed by diagnostic nerve block. They were given bursts of TENS for 20-40 days over the path of the affected nerve and subsequently evaluated at 1 month and 3 month intervals by visual analogue scale (VAS), verbal pain scale (VPS), a functional outcome scales for main daily activities like sleep, chewing, talking, or washing face.Results:The results showed that, on VAS, the score decreased from 8.9 (Pre TENS) to 3.1 at 1 month and 1.3 at 3 months, and on VPS, the score decreased from 3.5 (Pre TENS) to 1.2 at 1 month and 0.3 at 3 months. Similarly, a considerable decrease in scores was seen on functional outcome scale for different activities. No side effects like irritation or redness of skin were seen in any of the patients.Conclusions:Thus, TENS was found to be a safe, easily acceptable, and non-invasive outdoor patient department procedure for management of trigeminal neuralgia.

Section: Introductionmentioning

confidence: 99%

Role of transcutaneous electric nerve stimulation in the management of trigeminal neuralgia

Prabhakar

Journal of Neurosciences in Rural Practice

2011

J of Invest & Clin Dent

“…In the absence of satisfactory pain control, or when patients are unable to tolerate higher doses, surgical options have been recommended 22,23 . Contrary to this, the present cohort of patients was treated using multiple drugs due to limitations in neurosurgical facilities for recommended procedures, such as microvascular decompression.…”

Section: Discussionmentioning

confidence: 99%

Use of single‐ and multi‐drug regimens in the management of classic (idiopathic) trigeminal neuralgia: an 11‐year experience at a single Sri Lankan institution

Ariyawardana

Pallegama

Sitheeque

et al. 2011

J. Maxillofac. Oral Surg.

“…The persistence of pain after pharmacological and injection (alcohol) therapies requires surgical intervention, these are the neurectomy of peripheral divisions of the trigeminal nerve and various neurosurgical procedures [10][11][12][13]. One of our patients reported to our institute with right side inferior alveolar neuralgia (not included in this study).…”

Section: Discussionmentioning

confidence: 99%

Peripheral Neurectomy: A Minimally Invasive Treatment for Trigeminal Neuralgia. A Retrospective Study

Agrawal

Kambalimath

2011

Aim Investigate the efficacy of peripheral neurectomy as a surgical procedure in the treatment of trigeminal neuralgia and to evaluate the results obtained by this procedure and their recurrences in a period of three years followup. Materials and Methods Thirty patients were retrospectively reviewed who underwent peripheral neurectomy. The factors analyzed were the demographic details of the patients, side of involvement, branch of nerve involved and procedure used postoperative complications, prognosis and any additional procedure used in cases of recurrences. Results The mean age of the patient was 57.1 years (range 35-71 years) more were males (M:F = 1.73:1) and the surgical treatment was peripheral neurectomy of the involved branch following failure of carbamazepine therapy. There was no intra operative and postoperative complications noted and follow up over 3 years revealed only two cases (6.66%) of recurrence. Two patients were lost to followup, total number evaluated between 0 and 3 years after treatment was 28 patients. Conclusion Peripheral neurectomy is one of the oldest, minimal invasive forms of surgery, well tolerated by the patient and can be done under local anesthesia.