Abstract
Background
Recurrent trigeminal neuralgia (RTN) is a common clinical problem and pain recurs in many patients after microvascular decompression (MVD). We evaluated the effect of adding pulsed radiofrequency to radiofrequency thermocoagulation at 60 ºC compared to radiofrequency thermocoagulation at 70 ºC alone in the treatment of recurrent trigeminal neuralgia after microvascular decompression.
Methods
40 patients with recurrent trigeminal neuralgia after microvascular decompression were randomly divided to two equal groups. Group A: received prolonged duration of pulsed radiofrequency followed by less destructive thermocoagulation, while group B: received sole thermocoagulation. Then patients followed up for 2 years to evaluate the success rate by the Barrow Neurological Institute Pain Intensity (BNI) Scale, complications, and the need to medical treatment.
Results
The success rate was 100% in both groups at discharge (BNI<III). It was 83.3% and 78.7% after 6 months, 77.8% and 68.4% after 12 month, 72.2% and 68.4% after 18 months and 66.7% and 63.1% after 24 months in group A and B respectively (p>0.05). In group A 88.9% of patients stopped tegretol treatment after the procedure compared to 84.2% in group B (p=0.32). 88.9% compared to 89.5% % in group A and B, respectively did not use tricyclic antidepressant (p =0.61). The overall complications in group A was 5.61%, while it was 36.8% in group B (p= 0.025).
Conclusion
Combined pulsed and thermal radiofrequency can significantly reduce the incidence of the side effects/complications with similar success rate than using thermal radiofrequency alone in treatment of recurrent trigeminal neuralgia after microvascular decompression.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/2mGJydm
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