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Trigeminal Neuralgia Type 1: Earlier Microvascular Decompression is Associated with Improved Outcome


Engel, Doortje C; Fournier, Jean Yves; Yetimoglu, Cem; Haile, Sarah R (2018). Trigeminal Neuralgia Type 1: Earlier Microvascular Decompression is Associated with Improved Outcome. International Journal of Neurorehabilitation, 5(2):307.

Abstract

Background: Medication therapy is commonly accepted as the initial treatment of trigeminal neuralgia (TN). Microvascular decompression (MVD) is the surgical treatment with the highest efficacy, but is considered as last tier therapy for patients with medication refractory pain or for those with unbearable side effects. The aim of this study was to investigate the association of symptom duration on outcome.
Methods: A retrospective study was conducted from 2001 through 2012. Patients were categorized according to Burchiel’s “Classification scheme for facial pains commonly encountered in neurosurgical practice”. Demographical, disease and treatment data as well as surgical data including complications and outcome were recorded and analyzed.
Results: In total, 65 patients were included. Distribution of diagnoses was as follows: TN type 1 (>50% episodic pain) n=54, TN type 2 (>50% constant pain) n=4, neuropathic TN n=1, symptomatic TN due to multiple sclerosis n=3, post herpetic n=2. Onset of disease to surgery was on average 7 years (<1-21 years). Shorter time from disease onset to surgery had a statistically significant association with a pain-free outcome in only TN type 1 patients (6 vs. 13 years, p=0.01). Overall success rate in TN1 was 88.9%. Overall mortality and morbidity rate were 3%. Overall complication rate was 13.5%.
Conclusion: Earlier MVD was significantly associated with better outcome. Patients should be informed about the option of MVD at an early stage of disease.

Abstract

Background: Medication therapy is commonly accepted as the initial treatment of trigeminal neuralgia (TN). Microvascular decompression (MVD) is the surgical treatment with the highest efficacy, but is considered as last tier therapy for patients with medication refractory pain or for those with unbearable side effects. The aim of this study was to investigate the association of symptom duration on outcome.
Methods: A retrospective study was conducted from 2001 through 2012. Patients were categorized according to Burchiel’s “Classification scheme for facial pains commonly encountered in neurosurgical practice”. Demographical, disease and treatment data as well as surgical data including complications and outcome were recorded and analyzed.
Results: In total, 65 patients were included. Distribution of diagnoses was as follows: TN type 1 (>50% episodic pain) n=54, TN type 2 (>50% constant pain) n=4, neuropathic TN n=1, symptomatic TN due to multiple sclerosis n=3, post herpetic n=2. Onset of disease to surgery was on average 7 years (<1-21 years). Shorter time from disease onset to surgery had a statistically significant association with a pain-free outcome in only TN type 1 patients (6 vs. 13 years, p=0.01). Overall success rate in TN1 was 88.9%. Overall mortality and morbidity rate were 3%. Overall complication rate was 13.5%.
Conclusion: Earlier MVD was significantly associated with better outcome. Patients should be informed about the option of MVD at an early stage of disease.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 January 2018
Deposited On:09 Aug 2019 12:08
Last Modified:25 Sep 2019 00:40
Publisher:OMICS Publishing Group
ISSN:2376-0281
OA Status:Green
Publisher DOI:https://doi.org/10.4172/2376-0281.1000307
Official URL:https://www.omicsonline.org/open-access/trigeminal-neuralgia-type-1-earlier-microvascular-decompression-is-associated-with-improved-outcome-2376-0281-1000307.pdf

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