Treatment of trigeminal neuralgia: role of radiofrequency ablation

Emril, Dessy Rakhmawati; Ho, Kah Leng

doi:10.2147/jpr.s14455

Cited by 38 publications

(20 citation statements)

References 36 publications

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“…The rate of these adverse events was within the previously reported range [7,12]. Overall, the number of patients who benefited (BNI grade ≤ III) from repeated PRT was increased to 28 (84.8%).…”

Section: Discussionsupporting

confidence: 76%

Repeated CT-Guided Percutaneous Radiofrequency Thermocoagulation for Recurrent Trigeminal Neuralgia

Tang

Jin²,

Li³

et al. 2014

Eur Neurol

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Aims: To investigate the long-term outcomes of repeated percutaneous radiofrequency thermocoagulation (PRT) for recurrent trigeminal neuralgia (TN) patients. Methods: Between 2002 and 2012, 33 patients with recurrent TN following an initial PRT procedure were retrospectively studied and underwent 43 repeated PRT procedures. Results: The mean length of follow-up after repeated PRT was 34 months. Pain relief was immediate in 30 patients (90.9%), and no pain relief occurred in 3 patients (9.1%) following a second PRT procedure. The percentage of patients who remained in an ‘excellent' and ‘good' pain relief condition (pain intensity ≤BIN grade III) after the second PRT procedure was 75% at 1 year, 68% at 2 years and 68% at 5 years, and 22 of these patients (54.5%) remained satisfied with their pain relief during the follow-up period. Nine patients underwent PRT three times and 1 patient four times. The total number of patients who benefited from repeated PRT was 28 (84.8%). Postprocedure complications including masseter weakness were present in 3 patients and limited mouth opening affected 1 patient. No mortalities were observed during or after repeated PRT procedures. Conclusion: Repeated PRT provides long-term pain relief benefits to patients with recurrent TN and should be considered as an alternative treatment for recurrent TN.

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Section: Discussionsupporting

confidence: 76%

Repeated CT-Guided Percutaneous Radiofrequency Thermocoagulation for Recurrent Trigeminal Neuralgia

Tang

Jin²,

Li³

et al. 2014

Eur Neurol

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“…Neither mortality nor life-threatening complications was observed, and the rate of adverse events conformed to the previous reports. 10 , 32 Our results suggest that PRT is a safe and effective therapy for the patients with recurrent TN after MVD. PRT management of TN is based on interrupting the pain by partial damage to the trigeminal nerve fiber; the destruction of the surrounding tissue is very limited and repeated PRT could be safe and effective.…”

Section: Discussionmentioning

confidence: 62%

CT-Guided Percutaneous Radiofrequency Thermocoagulation for Recurrent Trigeminal Neuralgia After Microvascular Decompression

et al. 2015

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This article evaluates the long-term outcomes of computed tomography (CT)-guided percutaneous radiofrequency thermocoagulation (PRT) for patients with recurrent trigeminal neuralgia (TN) after microvascular decompression (MVD).This is a retrospective study of 41 patients with intractable TN who after MVD underwent CT-guided PRT procedures between 2002 and 2012.The mean length of follow-up after PRT was 44.4 months. Immediate pain relief was in 37 patients (90.2%); the percentage of patients who remained in “excellent” or “good” pain relief condition after CT-guided PRT procedure was 85% at 1 year, 80% at 2 years, 51% at 5 years, and 41% at 10 years. Six patients received the second PRT and all achieved “excellent” or “good” pain relief. In total, 34 of these patients (82.9%) received multi-PRT procedure and remained satisfied with their pain relief during the follow-up period. Postoperative complications included facial numbness in 36 patients, limited eyes opening in 1 patient, ear paresthesia in 1 patient, no tears in 1 patient, and taste hypesthesia in 1 patient; these symptoms were all improved in the process of follow-up and their life had not severely affected. No mortality was observed during and after CT-guided PRT procedures.CT-guided PRT should be considered as an alternative treatment for patients with recurrent TN after MVD.

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“…[ 1 ] Microvascular decompression (MVD) may be considered over other techniques to provide the longest duration of pain freedom. [ 2 ] Younger patients benefit from MVD whereas the elderly patients with poor risk are more suitable for percutaneous procedures[ 3 ] and gamma knife radiosurgery (GKRS). [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Type 1 as intermittent and Type 2 as constant pain represent distinct clinical, pathological, and prognostic entities. Although multiple mechanism involving peripheral pathologies at root (compression or traction), and dysfunctions of brain stem, basal ganglion, and cortical pain modulatory mechanisms could have role, neurovascular conflict is the most accepted theory. Diagnosis is essentially clinically; magnetic resonance imaging is useful to rule out secondary causes, detect pathological changes in affected root and neurovascular compression (NVC). Carbamazepine is the drug of choice; oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate are also useful. Multidrug regimens and multidisciplinary approaches are useful in selected patients. Microvascular decompression is surgical treatment of choice in TN resistant to medical management. Patients with significant medical comorbidities, without NVC and multiple sclerosis are generally recommended to undergo gamma knife radiosurgery, percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation procedures. Partial sensory root sectioning is indicated in negative vessel explorations during surgery and large intraneural vein. Endoscopic technique can be used alone for vascular decompression or as an adjuvant to microscope. It allows better visualization of vascular conflict and entire root from pons to ganglion including ventral aspect. The effectiveness and completeness of decompression can be assessed and new vascular conflicts that may be missed by microscope can be identified. It requires less brain retraction.

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Treatment of trigeminal neuralgia: role of radiofrequency ablation

Cited by 38 publications

References 36 publications

Repeated CT-Guided Percutaneous Radiofrequency Thermocoagulation for Recurrent Trigeminal Neuralgia

Repeated CT-Guided Percutaneous Radiofrequency Thermocoagulation for Recurrent Trigeminal Neuralgia

CT-Guided Percutaneous Radiofrequency Thermocoagulation for Recurrent Trigeminal Neuralgia After Microvascular Decompression

Trigeminal neuralgia

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