| Recurrent or Persistent Trigeminal Neuralgia after Various Surgical Modalities |
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Moon Young Chung, In Bo Han, Ryoong Huh, Sang Sup Chung |
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Department of Neurosurgery, CHA University, Bundang CHA Hospital, Sungnam, Korea |
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| Abstract |
Objective
In cases of recurrent or persistent trigeminal neuralgia (TN), additional surgical procedures may be required after initial surgery. However, it is unclear how best to treat patients with recurrent or persistent TN. The aim of this study was to evaluate the subsequent therapeutic options for recurrent or persistent TN and to identify factors associated with the recurrence or persistence of TN.
Method: The authors reviewed 29 patients (15 female /14 male) who underwent retreatment for recurrent or persistent symptoms
after an initial operation. The mean age of retreated patients was 51.1 years (range 21-73 years), and the mean follow-up was
56.4 months (range 12-78.7 months) from final treatment.
Results
Of the 29 patients, pain relief was complete in 45 % (n=13), partial in 48% (n=14), and absent in 7 % (n=2) after final treatment. Final treatments were as follows: microvascular decompression (MVD) in 12 patients, percutaneous rhizotomy in 10,
and radiosurgery in 7. One of the patients that did not improve after final treatment suffered from dysesthetic facial pain and
the other had no offending vessel.
Conclusion
Based on our experiences, we concluded the following: 1) The majority of patients achieve satisfactory pain relief
after retreatment, 2) Percutaneous ablative procedures are recommended for most patients with recurrent pain after MVD, 3) MVD
is effective in patients with a history of failed percutaneous procedures, 4) Radiosurgery can be utilized to treat those that have not responded to other surgical modalities, 5) Persistent pain may be associated with dysesthetic facial pain. |
| Key Words:
Trigeminal neuralgia, Microvascular decompression, Radiosurgery, Recurrence, Rhizotomy. |
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