Trigeminal neuralgia: updated management

Jacques Magnan; Bhavin Parikh; Pradeep Vundavalli

doi:10.14748/ssm.v0i0.7846

Trigeminal neuralgia: updated management

Jacques Magnan, Bhavin Parikh, Pradeep Vundavalli

Abstract

The so-called idiopathic trigeminal neuralgia is easily diagnosed by the clinical history of the patient and present a constant cause, a neurovascular conflict in the cerebellopontine angle in the majority of cases, which is clearly identified by MRI assessment. Knowing the cause, after a trial period with a medical treatment, a curative surgical solution can be now offered to the patient when the medications do not provide a pain-free result or when the patients wish a more definitive solution. Combining the use of both operating microscope and endoscope increases the efficiency of the neurovascular decompression and decreases drastically the potential morbidity of the surgical procedure. From 355 patients suffering of trigeminal neuralgia who underwent endoscope-assisted retrosigmoid approach, the authors present their experiences and results.

Keywords

trigeminal neuralgia

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References

Rovit R, Murali R, Jannetta P, editors. Trigeminal neuralgia. Baltimore: Williams &Wilkins; 1990.

Trousseau A. De la nevralgie epileptiforme. Arch Gen Med. 1853; 1:33-44.

Fromm G, Terrence C, Maroon J. Trigeminal neuralgia. Current concepts regarding etiology and pathogenesis. Arch Neurol. 1984;41(11):1204-7. doi: 10.1001/archneur.1984.04050220102026.

Dandy W. Concerning the cause of trigeminal neuralgia Am J Surg. 1934;24(2):447-55. doi: 10.1016/S0002-9610(34)90403-7.

Gardner J. Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg. 1962;19:947-58. doi: 10.3171/jns.1962.19.11.0947.

Jannetta P. Trigeminal neuralgia and hemifacial spasm- etiology and definitive treatment. Trans Am Neurol Assoc. 1975;100:89-91.

Balansard ChF, Meller R, Bruzzo M, Chays A, Girard N, Magnan J. Névralgie du trijumeau: résultats de la décompression vasculaire micro-chirurgicale et endoscopique [Trigeminal neuralgia: results of microsurgical and endoscopic-assisted vascular decompression]. Ann Otolaryngol Chir Cervicofac. 2003;120(6):330-7.

Magnan J, Parikh B, Miyazaki H. Functional surgery of cerebellopontine angle by minimally invasive retrosigmoid approach. Jaypee Brothers Medical Publishers; 2013.

Elaini S, Miyazaki H, Rameh C, Deveze A, Magnan J. Correlation between magnetic resonance imaging and surgical findings in vasculo-neural compression syndrome. Int Adv Otol. 2009; 5(3):1-23.

Tien RD, Wilkins RH. MRA delineation of the vertebro-basilar system in patients with hemifacial spasm and trigeminal neuralgia. AJNR Am J Neuroradiol. 1993; 14(1):34–6.

Obermann M. Recent advances in understanding/managing trigeminal neuralgia. F1000Res. 2019;8:F1000 Faculty Rev-505. doi: 10.12688/f1000research.16092.1.

Beydoun A. Safety and efficacy of oxcarbazepine: results of randomized, double-blind trials. Pharmacotherapy. 2000;20(8 Pt 2):152S-158S. doi: 10.1592/phco.20.12.152s.35254.

Zakrzewska JM, Chaudhry Z, Nurmikko TJ, Patton DW, Mullens LE. Lamotrigine (lamictal) in refractory trigeminal neuralgia: results from a double-blind placebo controlled crossover trial. Pain. 1997;73(2):223-30. doi: 10.1016/S0304-3959(97)00104-8.

Fromm GH, Terrence CF, Chattha AS. Baclofen in the treatment of trigeminal neuralgia: double-blind study and long-term follow-up. Ann Neurol. 1984;15(3):240–4. doi: 10.1002/ana.410150306.

Kustermans L, Van Buyten JP, Smet I, Coucke W, Politis C. Stimulation of the Gasserian ganglion in the treatment of refractory trigeminal neuropathy. J Craniomaxillofac Surg. 2017;45(1):39-46. doi: 10.1016/j.jcms.2016.10.014.

Jakobs M, Unterberg A, Treede RD, Schuh-Hofer S, Ahmadi R. Subcutaneous trigeminal nerve field stimulation for refractory trigeminal pain: a cohort analysis. Acta Neurochir (Wien). 2016;158(9):1767-74. doi: 10.1007/s00701-016-2881-6.

Kolodziej MA, Hellwig D, Nimsky C, Benes L. Treatment of central deafferentation and trigeminal neuropathic pain by motor cortex stimulation: Report of a series of 20 patients. J Neurol Surg A Cent Eur Neurosurg. 2016;77(1):52-8. doi: 10.1055/s-0035-1558419.

Antal A, Terney D, Kühnl S, Paulus W. Anodal transcranial direct current stimulation of the motor cortex ameliorates chronic pain and reduces short intracortical inhibition. J Pain Symptom Manage. 2010;39(5):890-903. doi: 10.1016/j.jpainsymman.2009.09.023.

Aoki KR. Review of a proposed mechanism for the antinociceptive action of botulinum toxin type A. Neurotoxicology. 2005;26(5):785-93. doi: 10.1016/j.neuro.2005.01.017.

McLaughlin MR, Jannetta PJ, Clyde BL, Subach BR, Comey CH, Resnick DK. Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg. 1999;90(1):1-8. doi: 10.3171/jns.1999.90.1.0001.

El-Garem HF, Badr-El-Dine M, Talaat AM, Magnan J. Endoscopy as a tool in minimally invasive trigeminal neuralgia surgery. Otol Neurotol. 2002;23(2):132-5. doi: 10.1097/00129492-200203000-00004.

Broggi G, Ferroli P, Franzini A, Servello D, Dones I. Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis. J Neurol Neurosurg Psychiatry. 2000;68(1):59-64. doi: 10.1136/jnnp.68.1.59.

Sun T, Saito S, Nakai O, Ando T. Long-term results of microvascular decompression for trigeminal neuralgia with reference to probability of recurrence. Acta Neurochir (Wien). 1994;126(2-4):144-8. doi: 10.1007/BF01476425.

Oesman C, Mooij JJ. Long-term follow-up of microvascular decompression for trigeminal neuralgia. Skull Base. 2011;21(5):313-22. doi: 10.1055/s-0031-1284213.

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. doi: 10.1111/j.1468-1331.2008.02185.x.

Zanoletti E, Mazzoni A, Martini A, Abbritti RV, Albertini R, Alexandre E, et al. Surgery of the lateral skull base: a 50-year endeavor. Acta ORL Ital 2019; 39(suppl.1):117-21. doi: 10.14639/0392-100X-suppl.1-39-2019.

DOI: http://dx.doi.org/10.14748/ssm.v0i0.7846

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