Surgical outcomes of trigeminal neuralgia in patients with multiple sclerosis

In this study from the US, the researchers looked at the surgical interventions for the treatment of MS-related trigeminal neuralgia (TN) compared with classic TN by evaluating initial pain-free response (IPFR), duration of pain-free intervals (PFI) and factors predictive of outcome in different surgical modalities used to treat MS-related TN.

The study included a total of 96 people with MS who underwent 277 procedures to treat TN over a 16-year period. Of these, 89 had percutaneous retrogasserian glycerol rhizotomies (PRGR), 82 had balloon compressions (BC), 52 had stereotactic radiosurgeries (SRS), 28 had peripheral neurectomies, 15 had percutaneous radiofrequency rhizotomies and 10 had microvascular decompressions either performed upfront or as repeat procedures.

The researchers found that 10% of people with MS experienced bilateral pain. Over the follow-up period (median of 5.7 years), 66% of people with MS had a recurrence of symptoms with 181 procedures carried out for symptom recurrence. Repeat procedures had lower effectiveness compared to initial procedures. There was no significant difference seen between the different treatment modalities. Therefore, treatment failure occurs in most on the MS-related TN patients independent of the type of treatment.

Authors: Mohammad-Mohammadi A, Recinos PF
Source: Neurosurgery. 2013 Aug 5. [Epub ahead of print]

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