Abstract
Objectives: To assess the efficacy of Cryosurgery for the treatment of Trigeminal neuralgia and to compare this procedure with Carbamazepine and alcohol block. Materials and method-A prospective study with 75 cases of Trigeminal neuralgia was carried out in the Department of Oral and Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University from January 2006 to December 2007. Out of 75 cases 25 treated with Carbamazepine only, starting dose 100 mg b.d. with incremental dose up to 800 mg, 25 received alcohol block with maintenance dose of Carbamazepine 200 mg b.d. over the study period and 25 received Cryosurgery with initial maintenance dose of Carbamazepine 100 mg b.d. then tappered on 1st follow up visits and withdrawn on the 2nd follow up visits. Visual linear analogue scale (VAS) was used to measure pain intensity in different groups. Results: Out of different treatment modalities on follow up onwards pain control was better in Cryosurgery than Carbamazepine and alcohol block. Conclusion: This study reveals that the efficacy of Cryosurgery is better than Carbamazepine and alcohol block to eliminate the pain intensity in Trigeminal neuralgia. DOI: http://dx.doi.org/10.3329/bjms.v11i3.11721 Bangladesh Journal of Medical Science Vol. 11 No. 03 July12
Highlights
Trigeminal Neuralgia, often called "tic douloureux," is one of the most painful and debilitating pain disorders[1]
A total of 75 patients involving 20% Inferior alveolar nerve alone, 22.7% Inferior alveolar and Mental, 42.7% Infraorbital, 13.3% Mental 1.3% Infraorbital and Mental nerve were divided in three equal groups and pain Intensity in different visits were measured by visual linear analogue scale (VAS)
In this study the type of nerve involvement was limited to maxillary and mandibular division but there is no involvement of ophthalmic division of trigeminal nerve
Summary
Trigeminal Neuralgia, often called "tic douloureux," is one of the most painful and debilitating pain disorders[1]. The diagnosis of trigeminal neuralgia is based primarily on a clinical history with some relevant general, physical and neurological examinations[2]. At present it is a standard practice to use carbamazepine as the first line of treatment, sometimes with addition of phenytoin. Even though many patients can be managed in the long term by carbamazepine, side effects become intolerant and quite a number of patients become failure and resistant to the drug and required a variety of surgical procedures. In order to avoid major surgery, numerous peripheral techniques have been used. None of the technique appears to be curative and some may cause complications such as neuromas, anaesthesia dolorosa and neurological deficits[3]
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