Mousavi SH, Gehling P, Burchiel KJ. The Long-Term Outcome of Radiofrequency Ablation in Multiple Sclerosis-Related Symptomatic Trigeminal Neuralgia.
Neurosurgery 2022;
90:293-299. [PMID:
35113822 DOI:
10.1227/neu.0000000000001817]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND
Radiofrequency lesioning (RFL) is used to surgically manage trigeminal neuralgia (TN) secondary to multiple sclerosis (MS). However, the long-term outcome of RFL has not been established.
OBJECTIVE
To investigate the long-term clinical outcome of RFL in MS-related TN (symptomatic trigeminal neuralgia [STN]).
METHODS
During a 23-yr period, institutional data were available for 51 patients with STN who underwent at least one RFL procedure to treat facial pain. Patient outcome was evaluated at a mean follow-up of 69 mo (95% confidence interval; range 52-86 mo). No pain with no medication (NPNM) was the primary long-term outcome measure.
RESULTS
After an initial RFL procedure, immediate pain relief was achieved in 50 patients (98%), and NPNM as assessed at 1, 3, and 6 yr was 86%, 52%, and 22%, respectively. At the last clinical visit after an initial RFL, 23 patients (45%) with pain recurrence underwent repeat RFL; NPNM at 1, 3, and 6 yr after a repeat RFL was 85%, 58%, and 32%, respectively. There was no difference in pain outcome after an initial and repeat RFL ( P = .77). Ten patients with pain recurrence underwent additional RFL procedures. Two patients developed mastication muscle weakness, one patient experienced a corneal abrasion, which resolved with early ophthalmological interventions, and one patient experienced bothersome numbness.
CONCLUSION
RFL achieves NPNM status in STN and can be repeated with similar efficacy.
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