Document Detail


Recurrent or refractory trigeminal neuralgia after microvascular decompression, radiofrequency ablation, or radiosurgery.
MedLine Citation:
PMID:  16419977     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Trigeminal neuralgia (TN) is characterized by paroxysmal lancinating pain in the trigeminal nerve distribution. When TN is refractory to medical management, patients are referred for microvascular decompression (MVD), radiofrequency ablation, or radiosurgery. After the initial treatment, patients may have refractory or recurrent symptoms requiring retreatment. The purpose of this study was to determine what factors are associated with the need for retreatment and which modality is most effective. METHODS: To define this population further, the authors evaluated a cohort of patients who required retreatment for TN. The mean follow-up periods were 51 months from the first treatment and 23 months from the last one, and these were comparable among treatment groups. CONCLUSIONS: Trigeminal neuralgia can recur after neurosurgical treatment. In this study the authors demonstrate that the number of patients requiring retreatment is not negligible. Lower retreatment rates were seen in patients who initially underwent radiosurgery, compared with those in whom MVD or radiofrequency ablation were performed. Radiosurgery was more likely to be the final treatment for recurrent TN regardless of the initial treatment. After retreatment, the majority of patients attained complete or very good pain relief. Pain relief after retreatment correlates with postoperative facial numbness.
Authors:
Rene O Sanchez-Mejia; Mary Limbo; Jason S Cheng; Joaquin Camara; Mariann M Ward; Nicholas M Barbaro
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2005-05-15
Journal Detail:
Title:  Neurosurgical focus     Volume:  18     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2005  
Date Detail:
Created Date:  2006-01-19     Completed Date:  2006-05-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e12     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, University of California, San Francisco 94143-0112, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Catheter Ablation / statistics & numerical data*
Decompression, Surgical / statistics & numerical data*
Female
Follow-Up Studies
Humans
Male
Microcirculation
Middle Aged
Radiosurgery / statistics & numerical data*
Recurrence
Retrospective Studies
Treatment Outcome
Trigeminal Neuralgia / epidemiology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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