Long-Term Results of Percutaneous Compression of the Gasserian Ganglion in Trigeminal Neuralgia

1997 ◽  
Vol 68 (1-4) ◽  
pp. 190-195 ◽  
Author(s):  
B. Abdennebi ◽  
L. Mahfouf ◽  
T. Nedjahi
1975 ◽  
Vol 42 (2) ◽  
pp. 140-143 ◽  
Author(s):  
Jürgen Menzel ◽  
Wolfgang Piotrowski ◽  
Helmut Penzholz

✓ This report is a follow-up study of 315 patients under 46 years old who suffered from trigeminal neuralgia and were treated by electrocoagulation of the Gasserian ganglion. The average follow-up period was 12.7 years, the maximum 33 years. Eighty percent had a return of pain, but 96.7% ultimately attained freedom from pain after repeat electrocoagulation.


Neurosurgery ◽  
1989 ◽  
Vol 24 (2) ◽  
pp. 239-245 ◽  
Author(s):  
Bernardo Fraioli ◽  
Vincenzo Esposito ◽  
Beniamino Guidetti ◽  
Giorgio Cruccu ◽  
Mario Manfredi

Abstract From 1976 to 1986, 681 patients with drug-refractory trigeminal neuralgia (TN)—typical in 641, symptomatic of multiple sclerosis in 23 and of tumor in 10, atypical in 5, and postherpetic in 2—were treated with various percutaneous procedures. Controlled differential thermocoagulation of the gasserian ganglion and/or retrogasserian rootlets was performed in 533 patients; glycerolization of the trigeminal cistern in 32; and compression of the gasserian ganglion by balloon catheter in 159, Results and complications of each procedure are assessed at a mean follow-up of 6.5 years for thermocoagulation, 5 years for glycerolization, and 3.5 years for compression. The following therapeutic protocol is proposed: 1) in TN patients at first operation: a) gasserian compression (or glycerolization, if experience warrants it) is indicated in all cases of typical TN, unless the 3rd division alone is affected; b) in the latter case and in symptomatic TN, we suggest thermocoagulation; 2) in recurrences: a) after glycerolization or gasserian compression, gasserian compression (or glycerolization) is indicated; b) after thermocoagulation or open surgery, thermocoagulation is suggested.


Neurosurgery ◽  
2006 ◽  
Vol 59 (6) ◽  
pp. 1252-1257 ◽  
Author(s):  
Anne Donnet ◽  
Manabu Tamura ◽  
Dominique Valade ◽  
Jean Régis

Abstract OBJECTIVE We have previously reported short-term results of a prospective open trial designed to evaluate trigeminal nerve radiosurgical treatment in intractable chronic cluster headache (CCH). Medium- and long-term results have not yet been reported. METHODS Ten patients presenting with a severe and drug-resistant CCH were enrolled (nine men, one woman). The radiosurgical treatment was performed according to the technique usually used for trigeminal neuralgia in our department. A single 4-mm shot was positioned at the level of the cisternal portion of the trigeminal nerve. The median distance between the center of the shot and the emergence of the nerve was 9.35 mm (range, 7.5–13.3 mm). The median of this maximum dose to the brainstem was 8.0 Gy (range, 4.0–11.1 Gy). Mean age was 49.8 years (range, 32–77 yr). Mean duration of the CCH was 9 years (range, 2–33 yr). The mean follow-up period was 36.3 months (range, 24–48 mo). RESULTS Two patients had complete relief of CCH. One patient had a good result with evolution in an episodic form. Seven patients had no improvement. Nine patients developed a new trigeminal nerve disturbance: three developed paresthesia with no hypoesthesia and six developed hypoesthesia, including two patients with deafferentation pain. Only one patient had neither paresthesia nor hypoesthesia. CONCLUSION We confirmed, with medium- and long-term evaluation, the high rate of toxicity and failure of the technique. The high toxicity, despite a methodology identical to the one used in trigeminal neuralgia, leads us to suspect an underlying specificity of the nerve in CCH. We do not recommend radiosurgery for treatment of intractable CCH.


Neurosurgery ◽  
2004 ◽  
Vol 55 (2) ◽  
pp. 469-469
Author(s):  
Jason P. Sheehan ◽  
Hung-Chuan Pan ◽  
Mateti Stroila ◽  
Ladislau Steiner

2002 ◽  
Vol 96 (3) ◽  
pp. 527-531 ◽  
Author(s):  
Elizabeth C. Tyler-Kabara ◽  
Amin B. Kassam ◽  
Michael H. Horowitz ◽  
Louise Urgo ◽  
Constantinos Hadjipanayis ◽  
...  

Object. Microvascular decompression (MVD) has become one of the primary treatments for typical trigeminal neuralgia (TN). Not all patients with facial pain, however, suffer from the typical form of this disease; many patients who present for surgical intervention actually have atypical TN. The authors compare the results of MVD performed for typical and atypical TN at their institution. Methods. The results of 2675 MVDs in 2264 patients were reviewed using information obtained from the department database. The authors examined immediate postoperative relief in 2003 patients with typical and 672 with atypical TN, and long-term follow-up results in patients for whom more than 5 years of follow-up data were available (969 with typical and 219 with atypical TN). Outcomes were divided into three categories: excellent, pain relief without medication; good, mild or intermittent pain controlled with low-dose medication; and poor, no or poor pain relief with large amounts of medication. The results for typical and atypical TN were compared and patient history and pain characteristics were evaluated for possible predictive factors. Conclusions. In this study, MVD for typical TN resulted in complete postoperative pain relief in 80% of patients, compared with 47% with complete relief in those with atypical TN. Significant pain relief was achieved after 97% of MVDs in patients with typical TN and after 87% of these procedures for atypical TN. When patients were followed for more than 5 years, the long-term pain relief after MVD for those with typical TN was excellent in 73% and good in an additional 7%, for an overall significant pain relief in 80% of patients. In contrast, following MVD for atypical TN, the long-term results were excellent in only 35% of cases and good in an additional 16%, for overall significant pain relief in only 51%. Memorable onset and trigger points were predictive of better postoperative pain relief in both atypical and typical TN. Preoperative sensory loss was a negative predictor for good long-term results following MVD for atypical TN.


2019 ◽  
Vol 5 (22;5) ◽  
pp. E467-E475
Author(s):  
Luo Fang

Background: Percutaneous radiofrequency thermocoagulation (PRFT) has been widely used to treat trigeminal neuralgia. By querying MEDLINE, EMBASE, and the Cochrane Library, no study has reported the long-term outcome of PRFT for tumor-related trigeminal neuralgia (TRTN). Objectives: In this study, we aimed to evaluate the long-term efficacy and safety of PRFT as an alternative treatment for TRTN. Study Design: A retrospective study. Setting: The interventional pain management center in Beijing Tiantan hospital. Methods: We retrospectively analyzed data of all patients who underwent PRFT applied to the Gasserian ganglion under computed tomography guidance for TRTN through a combination of available institutional electronic medical records, patient notes, and radiologic images. Results: Among 38 patients with PRFT treated between March 2007 and February 2018, 13 patients were men and 25 were women. All patients were evaluated as modified Barrow Neurological Institute (BNI) IV-V before the operation and had a total symptom duration of 45.55 ± 23.31 months. The mean operation duration was 59.63 ± 16.89 minutes. All patients experienced satisfactory pain relief defined as a classification of BNI I-IIIb within 3 days after PRFT. The median remission length with satisfactory pain relief was 33 (range, 4-132) months. No serious intraoperative complications, except bradycardia in 6 patients, were recorded. Postprocedure complications, including masticatory muscle weakness, were reported in 5 patients. Although all 38 patients experienced facial dysesthesia, the patients’ Likert scale rating represented that quality of life significantly increased after the procedure. Limitations: The small sample size may have unavoidably caused selection bias in our study. Larger prospective, randomized, multicenter trials are necessary to validate our outcomes. Conclusions: PRFT is an effective and safe treatment that should be considered as an alternative for pain control in the treatment of TRTN. Key words: Pain, secondary trigeminal neuralgia, radiofrequency thermocoagulation, trigeminal neuralgia


2020 ◽  
Author(s):  
yi ma ◽  
Yan-feng Li ◽  
Hai-tao Huang ◽  
Bin Wang ◽  
Quan-cai Wang

Abstract Background. We aimed to present the immediate and long term effect of percutaneous balloon compression (PBC) for idiopathic trigeminal neuralgia (ITN). Methods. ITN patients who underwent PBC for the first time in the past seven years were enrolled. Base line data and immediate postoperative outcomes were collected by reviewing the medical records and long term results. Kaplan-Meier curve, life-table analysis proportional-hazards analysis were utilized to assess the long term results and the likelihood of tic recurrence. Results. 12,797 patients were enrolled. Immediate after the PBC procedure, complete and partial pain relief were achieved in 95.6% and 1.1% patients respectively, with no relief in 1.7 % patients; the common side effects on the affected side of face included the sense loss in 98.9% patients, with 3.8% of them experienced sense loss combined abnormal sense; masseter weakness in 90.6%, herpes eruption in 51.4%, corneal reflex weakness or loss in 12.7% patients. The fewer perioperative complications covered diplopia in 139 patients (1.1%), partial hearing loss in 190 patients (1.5%), vascular complications in 5 patients (0.05%), brainstem hematoma in one patient (0.01%), ischemic stroke in two patients (0.02%), intracranial hemorrhage in 11 patents (0.09%), and intracranial infection in one patient (0.01%) patients. Of three deaths happened in the perioperative period, two died of intracranial hemorrhage, and the other one died of intracranial infection. 5794 (49.2%) patients, who were followed than one year after the procedure, were included in the follow-up study, with the median follow-up period of 7.2 years. Complete and partial pain relief were obtained in 82.9% and 6.8% patients respectively, while the pain recurrence occurred in 8.5% patients. Side effects included sense loss without abnormal sense in 54.3%, with acceptable abnormal sense in 6.0%, and with severe abnormal sense in 2.0% patients. Masseter weakness was reported by 7.5% patients. 96.4% patients were satisfied with the procedure. Conclusion. Our study shows PBC is a safe, simple and effective procedure, with both immediate and long-term success rates, acceptable side effects and fewer deadly complications, should be considered as one of the best choice for the treatment of ITN patients.


1996 ◽  
Vol 75 (9) ◽  
pp. 601-606 ◽  
Author(s):  
Jack L. Pulec

Patients frequently consult otolaryngologists for the treatment of trigeminal neuralgia. Retrolabyrinthine selective posterior root section of the fifth cranial nerve effectively and permanently eliminates pain from areas supplied by this nerve without the production of annoying anesthesia dolorosa. The procedure is performed by the neurotologist and causes minimum morbidity. The results of this surgery in 106 patients are reviewed and demonstrate that the procedure provides lasting relief from intractable pain from a variety of conditions whose innervation is the Vth cranial nerve as well as trigeminal neuralgia. The surgical technique and long-term results are described.


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