Triple Puncture for Primary Trigeminal Neuralgia: A Randomized Clinical Trial

Zhang, Yangpu; Wang, Yan; Xia, Wenguang; Song, Aiqun

doi:10.1007/s11596-019-2085-4

Cited by 8 publications

(6 citation statements)

References 22 publications

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“…The effective rate of carbamazepine in this group of patients was approximately 73.77%. It was close to the effective rate of 75.9% for carbamazepine in trigeminal neuralgia ( 19 ). Only three patients in this group had symptoms of episodic arrhythmias such as bradycardia but had no serious events such as syncope.…”

Section: Discussionsupporting

confidence: 75%

Comparative analysis of MVD and RHZ in the treatment of primary glossopharyngeal neuralgia: A clinical report on 61 cases

Wang

Liu²,

Xiao³

et al. 2023

Front. Neurol.

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ObjectiveClinical data on 61 patients (grouped by their treatment with MVD or RHZ) with glossopharyngeal neuralgia were analyzed retrospectively. A summary analysis of the effective rate and surgical complications of MVD and RHZ in the treatment of glossopharyngeal neuralgia was performed to observe the new surgical options for GN.MethodFrom March 2013 to March 2020, 63 patients with GN were admitted to our hospital by the professional group of cranial nerve diseases. Two patients diagnosed with tongue and pharynx pain secondary to tongue cancer and upper esophageal cancer, respectively were excluded from the group. The remaining patients all met the diagnosis of GN, some of them were treated with MVD and others were treated with RHZ. The pain relief rate, long-term results, and complications of the patients in the two groups were well-organized and analyzed.ResultOf the 61 patients, 39 were treated with MVD and 22 were treated with RHZ. In the early-stage patients (the first 23 patients), all of them were operated on with the MVD procedure except one patient without vascular compression. In the later-stage patients, MVD was performed for evident single arterial compression according to the intraoperative situation. And for compression of arteries with greater tension or PICA + VA complex compression, RHZ was performed. It was also performed in cases where vessels with tight adhesions to the arachnoid and nerves could not be easily separated, or where it was easy to damage the perforating arteries after separating the blood vessels, causing vasospasm, which affects the blood supply to the brainstem and cerebellum. RHZ was also performed if there was no clear vascular compression. The efficiency of both groups was 100%. In the MVD group, one case recurred 4 years after the initial operation, and RHZ was performed for reoperation. Complications related to the operation included one case of swallowing and coughing in the MVD group, and three cases in the RHZ group; two cases of uvula not centering in the MVD group, and five cases in the RHZ group. There was 2 patients in RHZ group lost taste in 2/3 of the backing of the tongue, though these symptoms mostly disappeared or decreased after follow-up. One patient in the RHZ group had developed tachycardia by the time of the long-term follow-up, but whether it was related to the surgery is still uncertain. In terms of serious complications, there were two cases of postoperative bleeding in the MVD group. Based on the clinical characteristics of the patients' bleeding, it was judged that the cause of the bleeding was ischemia and was related to an intraoperative injury to the penetrating artery of the PICA artery and vasospasm.ConclusionMVD and RHZ are effective methods for the treatment of primary glossopharyngeal neuralgia. MVD is recommended for cases where vascular compression is clear and easy to handle. However, for cases with complex vascular compression, tight vascular adhesions, difficult separation, and without clear vascular compression, RHZ could be performed. Its efficiency is equivalent to MVD, and there is no significant increase in complications such as cranial nerve disorders. There are few cranial nerve complications that seriously affect the quality of life of patients. RHZ helps to reduce the risk of ischemia and bleeding during surgery by reducing the risk of arterial spasms and injury to the penetrating arteries by separating the vessels due to separation of vessels during MVD. At the same time, it may reduce the postoperative recurrence rate.

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Section: Discussionsupporting

confidence: 75%

Comparative analysis of MVD and RHZ in the treatment of primary glossopharyngeal neuralgia: A clinical report on 61 cases

Wang

Liu²,

Xiao³

et al. 2023

Front. Neurol.

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“…All trials were incorporated in the final Bayesian network meta-analysis. A total of 56 RCTs [11,[38][39][40][41][42][43][44][45][46][47][48][49][50][51] were written in Chinese, while two studies [17,52] were published in English. All the 58 articles were reported between 2004 and 2021. e studies were grouped at a 1 :1 ratio.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…e methodology quality of the included RCTs was assessed. (1) Randomisation process: only two trials [45,58] were ranked as "low risk" because they had detailed information, while 56 trials were ranked as "unclear" due to insufficient information. (2) Deviations from intended interventions: all trials had insufficient information on intended interventions and were ranked as "some concerns."…”

Section: Study Quality Assessmentmentioning

confidence: 99%

Acupuncture Methods for Primary Trigeminal Neuralgia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Yin

Wang

Sun

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Primary trigeminal neuralgia (PTN) is a clinical refractory disorder characterized by excruciating pain that severely impacts the quality of life. Several studies have shown that acupuncture can improve PTN pain. However, the comparative efficacy and safety of acupuncture are unknown. Herein, a systematic review was conducted to compare the efficacy and safety of various acupuncture methods for PTN treatment. Methods. Relevant randomized controlled trials (RCTs) published up to 1 August 2021 were obtained from PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, CQVIP Database, Wanfang Database, Allied and Alternative Medicine Database, and related registration platforms. Two authors independently selected the studies and obtained data. Cochrane Handbook was used to assess the methodological quality. We put the pain relief as the primary outcome and the response rate and adverse events as the secondary outcomes. Review Manager v5.3, ADDIS v1.16.8, and STATA v15.0 software were used for data analysis. The intraclass correlation coefficient was used to assess the consistency of the two investigators. Results. A total of 58 RCTs with 4,126 participants were obtained. The meta-analysis indicated that five acupuncture methods were superior to conventional medicine (carbamazepine) in pain reduction intensity and response rate. Meanwhile, electronic acupuncture plus manual acupuncture was the most effective therapy since it reduced pain intensity in 11 methods and improved the response rate in 10 interventions. Moreover, six interventions had acceptable adverse events, and none of the included studies reported severe adverse events. However, most pieces of evidence were ranked as critically low. Conclusion. These findings show that acupuncture methods can be effective and safe for PTN. Moreover, electronic acupuncture plus manual acupuncture maybe the best acupuncture treatment for PTN and should be administered to PTN patients. However, additional well-designed and high-quality RCTs should be conducted to verify the above findings in the future. The systematic review is registered with CRD42020221456.

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“…Ichida 14 concluded that ITN can be treated with acupuncture since it has analgesic effects on ITN and the associated secondary myofascial pain. Zhang 15 found primary trigeminal neuralgia (pTN) patients can benefit from triple punctures significantly with few side effects.…”

Section: Introductionmentioning

confidence: 99%

The Central Response of Electroacupuncture on Trigeminal Neuralgia Based on Resting-State Functional Magnetic Resonance Imaging: A Protocol for a Pre-Experimental, Single-Centre, Randomized, Controlled Trial

Tang

Zhang

et al. 2021

JPR

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Triple Puncture for Primary Trigeminal Neuralgia: A Randomized Clinical Trial

Cited by 8 publications

References 22 publications

Comparative analysis of MVD and RHZ in the treatment of primary glossopharyngeal neuralgia: A clinical report on 61 cases

Comparative analysis of MVD and RHZ in the treatment of primary glossopharyngeal neuralgia: A clinical report on 61 cases

Acupuncture Methods for Primary Trigeminal Neuralgia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

The Central Response of Electroacupuncture on Trigeminal Neuralgia Based on Resting-State Functional Magnetic Resonance Imaging: A Protocol for a Pre-Experimental, Single-Centre, Randomized, Controlled Trial

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