IMMEDIATE PAIN RELIEF BY MICROVASCULAR DECOMPRESSION FOR IDIOPATHIC TRIGEMINAL NEURALGIA
Abstract
Background: Trigeminal neuralgia is a common entity which is managed by neurosurgeons in day to day practice. Up-till now many treatment options have been adopted for it but micro-vascular decompression is much impressive in terms of pain control and recurrence rate in all of them. The objective of study was known the efficacy of micro vascular decompression for idiopathic trigeminal neuralgia by using muscle patch in terms of immediate pain relief. Methods: This descriptive study was carried out in Neurosurgery Department lady reading hospital, Peshawar from January 2010 to December 2012. All patients who underwent micro vascular decompression for idiopathic trigeminal neuralgia were included in the study. Patients were assessed 72 hours after the surgery by borrow neurological institute pain scale (BNIP scale) for pain relief and findings were documented on predesigned pro forma. Data was analysed by SPSS-17. Results: Total 52 patients were included in this study. Among these 32 (61.53%) were female and 20 (38.46%) were males having age from 22-76 years (mean 49 years). Right side was involved in 36 (69.23%) and left side in 16 (30.76%) patients. Duration of symptoms ranged from 6 months to 16 years (mean 8 years). History of dental extraction and peripheral neurectomy was present in 20 (38%) and 3(5.76%) patients while V3 was most commonly involved branch with 28(57.69%) frequency and combined V2,V3 involvement was 1 (11.53%). Superior cerebellar artery was most common offending vessel in 46(88.46%) while arachnoid adhesions were in 2(3.84%) patients. We assessed patient's immediate postoperatively using BNIP pain scale. Conclusion: Micro-vascular decompression is most effective mode of treatment for trigeminal neuralgia in terms of immediate pain relief.References
Sheehan JP, Ray DK, Montieth S, Yen CP, Lesnick J, Kersh R, et al. Gamma knife radio-surgery for trigeminal neuralgia: the impact of magnetic resonance imaging-detected vascular impingement of the affected nerve. J Neurosurg 2010;113:53-8.
Bennett OL, Patel NK, Fuller G. Trigeminal neuralgia and its management. BMJ 2009;334(7586):201-5.
Janetta PJ. Vascular compression is the cause of Trigeminal Neuralgia. APS J 1993;2:217-27.
Moore KR, Burchiel KJ. The practice of neurosurgery In: Surgical management of trigeminal neuralgia. Baltimore: Williams & Wilkins 1996. p.3043-64.
Cheshire WP. Trigeminal neuralgia: a guide to drug choice. CNS Drugs 1997;7(2):98-110.
Rehman A, Abbas I, Khan SA, Ahmed E, Fatima F, Anwar SA. Spectrum of trigeminal neuralgia J Ayub Med Coll Abbottabad 2013;25(1-2):168-71.
Sindrup SH, Jensen TS. Pharmacotherapy of trigeminal neuralgia. Clin J Pain 2002;18(1):22-7.
Adamczyk M, Bulski T, Sowińska J, Furmanek A, Bekiesińska FM. Trigeminal nerve - artery contact in people without trigeminal neuralgia-MR study. Med Sci Monit 2007;13:38-43.
Kress B, Schindler M, Rasche D, Hahnel S, Tronnier V, Sartor K, et al. MRI volumetry for the preoperative diagnosis of trigeminal neuralgia. Eur Radiol 2005;15(7):1344-8.
Satoh T, Onoda K, Date I. Preoperative simulation for microvascular decompression in patients with idiopathic trigeminal neuralgia: Visualization with three-dimensional magnetic resonancecisternogram and angiogram fusion imaging. Neurosurgery 2007;60(1):104-13.
Cheshire WP. Trigeminal neuralgia: for one nerve a multitude of treatments. Expert Rev Neurother 2007;7(11):1565-79.
Campbell FG, Graham JG, Zilkha KJ. Clinical trial of carbamazepine (tegretol) in trigeminal neuralgia. J Neurol Neurosurg Psychiatry 1966;29(3):265-7.
Cruccu G, Gronseth G, Alksne J, Argoff C, Brainin M, Burchiel K, et al. AAN-EFNS guidelines on trigeminal neuralgia management. Eur J Neurol 2008;15(10):1013-28.
Jorns TP, Zakrzewska JM. Evidence-based approach to the medical management of trigeminal neuralgia. Br J Neurosurg 2007;21(3):253-61.
Zakrzewska JM, Chaudhry Z, Nurmikko TJ, Patton DW, Mullens EL. Lamotrigine (lamictal) in refractory trigeminal neuralgia: results from a double-blind placebo controlled crossover trial. Pain 1997;73(2):223-30.
Royal M, Wienecke G, Movva V. Open label trial of ox carbamazepine in neuropathic pain. Pain Med 2001;2:151-5.
Sekula RF Jr, Frederickson AM, Jannetta PJ, Bhatia S, Quigley MR. Microvascular decompression after failed gamma knife surgery for trigeminal neuralgia: a safe and effective rescue therapy?.J Neurosurg 2010;113(1):45-52.
Dieckmann G, Bockermann V, Heyer C, Henning J, Rosen M. Five and a half years' experience with percutaneous retrogasserian glycerol rhizotomy in treatment of trigeminal neuralgia. Appl Neurophysiol 1987;50(1-6):401-13.
OlesenJ. The international classification of headache disorders. 2nd edition (ICHD-II). Rev Neurol (Paris) 2005;161(6-7):689-91.
Suzuki N. New international classification of headache disorders (ICHD-II). Rinsho Shinkeigaku 2004;44(11):940-3.
Tang CT, Chang SD, Tseng KY, Liu MY, Ju DT. Cyber knife stereotactic radiosurgical rhizotomy for refractory trigeminal neuralgia. J ClinNeurosci 2011;18(11):1449-53.
Dandy WE. Concerning the cause of trigeminal neuralgia. Am J Surg1934;24(2):447-55.
Gardner WJ, Miklos MV. Response of trigeminal neuralgia to decompression of sensory root. Discussion of cause of trigeminal neuralgia. J Am Med Assoc 1959;170(15):1773-6.
Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 1967;26(1):159-62.
Broggi G,Ferroli P,Franzini A,Servello D,Dones I. Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases. J NeurolNeurosurg Psychiatry.2000;68:59-64.
Kabatas S,Albayrak SB,Cansever T,HepgulKT.Microvascular decompression as a surgical management for trigeminal neuralgia: a critical review of the literature.Neurol India2009;57(2):134-8.
Shams S, Butt FS. Trigeminal neuralgia. Professional Med J 2005;12:408-11.
Zhang L,Zhang Y,Li C,Zhu S.Surgical treatment of primary trigeminal neuralgia: comparison of the effectiveness between MVD and MVD+PSR in a series of 210 patients.Turk Neurosurg. 2012;22(1):32-8.
Khan SA, Khan B, Khan AA, Afridi EAK, Mehmood S, Muhammad G. Microvascular decompression for trigeminal neuralgia. J Ayub Med Coll Abbottabad 2015;27(3):539-42.
Chen HI, Lee JYK. The measurement of pain in patients with trigeminal neuralgia.Clin Neurosurg 2010;57:129-33.
Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the barrow neurological institute. Int J RadiatOncolBiol Phys 2000;47(4):1013-19.
Park SH, Hwang SK. Outcomes of gamma knife radiosurgery for trigeminal neuralgia after a minimum 3-year follow-up. J ClinNeurosci 2011;18(5):645-8.
Broggi G, Ferroli P, Franzini A, Servello D, DonesI.Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis. J NeurolNeurosurg Psychiatry 2000;68(1):59-64.
Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD.The longterm outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med1996;334(17):1077-83.
Forbes J, Cooper C, Jermakowicz W, Neimat J, Konrad P. Microvasculardecompression: salient surgical principles and technical nuances. J Vis Exp 2011;8(53):e2590.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.