PERCUTANEOUS THERMORHIZOTOMY IN A CLINICAL SERIES OF 80 PATIENTS WITH TRIGEMINAL NEURALGIA.

Abstract

At the time of this report, 80 patients have been operated upon for typical trigeminal neuralgia by the percutaneous rhizotomy approach. Through follow‐up evaluation extending over a period of 1 to 20 years, it has been completed for 65 of these patients. The average age was 63 years and 60% of patients were female. In 60% of patients pain was located on the right, and the second and third division of the trigeminal nerve were commonly involved. Isolated pain in the first or third division was less frequent than the second division. The disease had been present for an average of 8 years and was characterized by increasingly severe episodes of paroxismal pain and shortening period of remission. Nearly all patients had been treated with either diphenylhydantoin or carbamazepine, as well as other forms of medical and physical remedies. Response to follow‐up was obtained for all 65 patients. All were contacted by questionnaire on phone and a family member was contacted if the patient had died. At the time of evaluation, 94% of patients reported excellent to good results from the procedure. The remaining patients obtained only fair results because of undesirable side‐effects or recurrence of pain. The authors emphasize the importance of surgical therapy in trigeminal neuralgia when medical therapy fails.