Percutaneous trigeminal nerve compression for treatment of trigeminal neuralgia: Results in 50 patients

Jeffrey A. Brown, Matthew D. McDaniel, Michael T. Weaver

Research output: Contribution to journalArticle

105 Scopus citations

Abstract

THE PURPOSE OF this study was to review the results of the treatment of trigeminal neuralgia by percutaneous trigeminal nerve compression in 50 patients during a period of 7.5 years and to review the factors associated with pain recurrence. Mean patient age was 61 years (range, 35–86). Among the patients, 52% had previous destructive peripheral procedures; 24% had first division pain; and 10% had multiple sclerosis. The mean follow-up was 3 years (range, 9 mo to 7.5 yr). Eighty-six percent of the patients were satisfied or very satisfied with their pain relief. Mild numbness persisted in 74%, and one patient thought it was severe. Minor masseter weakness resolved in all patients in a maximum of 1 year. Aseptic meningitis occurred in 3 patients. Minor dysesthesia was seen in 20%. Transient 6th nerve palsy was present in one patient. Anesthesia dolorosa or absence of the corneal reflex did not happen. The recurrence rate was 26% (13/50). The mean time until recurrence was 1.5 years (range, 14 d to 3.5 yr). Sixty-two percent (8/13) of patients with recurrence required a subsequent compression. When another compression was done, four of eight had recurrent pain once again. Three of these four patients had undergone two to eight previous destructive procedures. Overall, 8 of 13 patients with recurrence had undergone previous destructive procedures. Early recurrence (in < 1 week) or failure to relieve pain occurred in 8% (4/50) of patients. Half of those with early failure had a subsequent compression. After compression, 70% of patients with recurrence did have numbness. The mean tissue compression pressure for patients without recurrence or failure (n = 9) when measured (823 ± 340 mm Hg) was not significantly different from that of patients with recurrence, 768 ± 218 mm Hg, n = 3 (P > 0.5). Kaplan-Meier survival curves for pain-free days were similar between patients who had previous destructive procedures and those who did not (P > 0.5). Percutaneous trigeminal compression continues to be an effective and technically simple treatment for trigeminal neuralgia.

Original languageEnglish (US)
Pages (from-to)570-573
Number of pages4
JournalNeurosurgery
Volume32
Issue number4
DOIs
StatePublished - Apr 1993

Keywords

  • Pain
  • Tic doulouroux
  • Trigeminal nerve
  • Trigeminal neuralgia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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