The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Experience with Conventional Radiofrequency Thermorhizotomy in Patients with Failed Medical Management for Trigeminal Neuralgia

  • Singh, Sarita (Department of Anaesthesiology, King George's Medical University) ;
  • Verma, Reetu (Department of Anaesthesiology, King George's Medical University) ;
  • Kumar, Manoj (Department of Radiology, King George's Medical University) ;
  • Rastogi, Virendra (Department of Anesthesia, Banaras Hindu University) ;
  • Bogra, Jaishree (Department of Anaesthesiology, King George's Medical University)
  • Received : 2014.01.10
  • Accepted : 2014.06.01
  • Published : 2014.07.01
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Abstract

Background: To evaluate the results of conventional radiofrequency thermorhizotomy (CRT) for trigeminal neuralgia (TN) in patients with failed medical management. Methods: Patients with Trigeminal neuralgia who were referred to us for 'limited intervention' during the time frame July-2011 to Jan-2013 were enrolled for this study. CRT was administered by the Sweet technique. Pain relief was evaluated by the principle investigator. Results: Eighteen patients were enrolled and completed a mean follow-up of 18.0 months. Pain relief was observed in 14 of 18 (77.8%) patients on the post-operative day, 14 of 18 (77.8%) at 1-month follow-up, 14 of 17 (82.4%) at 3-months follow-up, 12 of 15 (80%) at 6-months follow-up, 7 of 11 (63.6%) at 1-year follow-up and 2 of 6 (33.3%) 1.5 years of follow-up. Four patients required a repeat cycle of CRT; two at six months of follow-up and two at one year of follow-up. One patient was transferred for surgical intervention at six months of follow-up. Side-effects included facial hypoesthesia (n = 6); nausea/vomiting (n = 2), diminished corneal reflex (n = 13) and difficulty in chewing (n = 11). Severity of adverse effects gradually diminished and none of the patients who are beyond 6 months of follow-up have any functional limitation. Conclusions: CRT is an effective method of pain relief for patients with Trigeminal neuralgia. Successful outcome (excellent or good) can be expected in 66.7% of patients after first cycle of CRF. The incidence and severity of adverse effects is less and the procedure is better tolerated by the patients.

Keywords

References

  1. Sweet WH, Wepsic JG. Controlled thermocoagulation of trigeminal ganglion and rootlets for differential destruction of pain fibers. 1. Trigeminal neuralgia. J Neurosurg 1974; 40: 143-56. https://doi.org/10.3171/jns.1974.40.2.0143
  2. Park SS, Lee MK, Kim JW, Jung JY, Kim IS, Ghang CG. Percutaneous balloon compression of trigeminal ganglion for the treatment of idiopathic trigeminal neuralgia : experience in 50 patients. J Korean Neurosurg Soc 2008; 43: 186-9. https://doi.org/10.3340/jkns.2008.43.4.186
  3. Cheshire WP. Trigeminal neuralgia feigns the terrorist. Cephalalgia 2003; 23: 230. https://doi.org/10.1046/j.1468-2982.2003.00484.x
  4. Obermann M, Yoon MS, Sensen K, Maschke M, Diener HC, Katsarava Z. Efficacy of pregabalin in the treatment of trigeminal neuralgia. Cephalalgia 2008; 28: 174-81.
  5. Sandell T, Eide PK. Effect of microvascular decompression in trigeminal neuralgia patients with or without constant pain. Neurosurgery 2008; 63: 93-9. https://doi.org/10.1227/01.NEU.0000335075.16858.EF
  6. Szapiro J Jr, Sindou M, Szapiro J. Prognostic factors in microvascular decompression for trigeminal neuralgia. Neurosurgery 1985; 17: 920-9. https://doi.org/10.1227/00006123-198512000-00009
  7. Campbell FG, Graham JG, Zilkha KJ. Clinical trial of carbazepine (tegretol) in trigeminal neuralgia. J Neurol Neurosurg Psychiatry 1966; 29: 265-7. https://doi.org/10.1136/jnnp.29.3.265
  8. Khan OA. Gabapentin relieves trigeminal neuralgia in multiple sclerosis patients. Neurology 1998; 51: 611-4. https://doi.org/10.1212/WNL.51.2.611
  9. Taylor JC, Brauer S, Espir ML. Long-term treatment of trigeminal neuralgia with carbamazepine. Postgrad Med J 1981; 57: 16-8. https://doi.org/10.1136/pgmj.57.663.16
  10. Bovaira M, Penarrocha M, Penarrocha M, Calvo A. Conventional radiofrequency treatment in five patients with trigeminal neuralgia. Med Oral Patol Oral Cir Bucal 2013; 18: e76-80.
  11. White JC, Sweet WH. Pain and the neurosurgeon. Springfield (IL), Charles C. Thomas. 1969.
  12. van Loveren H, Tew JM Jr, Keller JT, Nurre MA. A 10-year experience in the treatment of trigeminal neuralgia. Comparison of percutaneous stereotaxic rhizotomy and posterior fossa exploration. J Neurosurg 1982; 57: 757-64. https://doi.org/10.3171/jns.1982.57.6.0757
  13. Tew JM Jr, Keller JT, Williams DS. Application of stereotactic principles to the treatment of trigeminal neuralgia. Appl Neurophysiol 1978; 41: 146-56.
  14. Letcher FS, Goldring S. The effect of radiofrequency current and heat on peripheral nerve action potential in the cat. J Neurosurg 1968; 29: 42-7. https://doi.org/10.3171/jns.1968.29.1.0042
  15. Brown JA. Percutaneous techniques. In: Youmans neurological surgery. 5th ed. Edited by Winn HR. Philadelphia (PA), Saunders. 2003, pp 2996-9.
  16. Liu C, Zhou ZG, Yuan CY. Treatment of primary trigeminal neuralgia with radiofrequency thermocoagulation: report of 648 consecutive cases. Shanghai Kou Qiang Yi Xue 2012; 21: 466-9.
  17. Erdine S, Ozyalcin NS, Cimen A, Celik M, Talu GK, Disci R. Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia. Eur J Pain 2007; 11: 309-13. https://doi.org/10.1016/j.ejpain.2006.04.001
  18. Chua NH, Halim W, Beems T, Vissers KC. Pulsed radiofrequency treatment for trigeminal neuralgia. Anesth Pain Med 2012; 1: 257-61. https://doi.org/10.5812/aapm.3493
  19. Kim JH, Yu HY, Park SY, Lee SC, Kim YC. Pulsed and conventional radiofrequency treatment: which is effective for dental procedure-related symptomatic trigeminal neuralgia? Pain Med 2013; 14: 430-5. https://doi.org/10.1111/pme.12046
  20. Fang L, Ying S, Tao W, Lan M, Xiaotong Y, Nan J. 3D CT-guided pulsed radiofrequency treatment for trigeminal neuralgia. Pain Pract 2014; 14: 16-21. https://doi.org/10.1111/papr.12041
  21. Chen MJ, Gu LX, Zhang WJ, Yang C, Dong MJ. Electromagnetic navigation-guided radiofrequency thermocoagulation in trigeminal neuralgia: technical note with three case reports. J Neurol Surg A Cent Eur Neurosurg 2013; 74: 251-7. https://doi.org/10.1055/s-0032-1330953

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