Experience in the use of high-frequency selective percutaneous rhizotomy in trigeminal neuralgia associated with multiple sclerosis

• Published in: Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko Vol. 79; no. 5; p. 34
• Main Authors: Tyurnikov, V M, Peresedova, A V, Gushcha, A O, Koval', K V
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 2015
• Subjects: Adult; Electrodes; Electrosurgery - methods; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis - complications; Multiple Sclerosis - diagnosis; Multiple Sclerosis - surgery; Retrospective Studies; Rhizotomy - methods; Stereotaxic Techniques; Treatment Outcome; Trigeminal Neuralgia - diagnosis; Trigeminal Neuralgia - etiology; Trigeminal Neuralgia - surgery
• ISSN: 0042-8817
• DOI: 10.17116/neiro201579534-42

the study was aimed at assessment of the efficacy of percutaneous high frequency selective rhizotomy (PHFSR) after failure of conservative treatment of trigeminal neuralgia (TN) in multiple sclerosis (MS).
A retrospective analysis of 28 patients with TN associated with MS who underwent percutaneous rhizotomy in the period from 2000 to 2014 was performed. All patients were definitely diagnosed with MS according to the McDonald criteria (version of 2001, 2005, and 2010). The patients were divided by age, gender, and the trigeminal nerve branches involved in the process. The patients' condition was evaluated at different times after surgery.
Good outcomes in the form of pain syndrome regression were achieved in 100% of the patients. A disease recurrence was observed in 6 (21%) patients during a follow-up period of 3 months to 14 years. Dysesthesia complications occurred in 4 (14%) patients. There were no deaths and severe complications. The percentage of minor complications was low.
These data confirm that PHFSR is a safe, repeatable, and effective method of symptomatic neurosurgical treatment of TN associated with MS and may be recommended in the case of failure/intolerance of medication.