Glycerol rhizotomy via a retrosigmoid approach as an alternative treatment for trigeminal neuralgia.

Published

Journal Article

OBJECTIVES: Trigeminal neuralgia is a sensory nerve disorder characterized by lancinating pain and treated most commonly with carbamazepine, rhizotomy treatment, or open surgical management with microvascular decompression. We describe a novel technique to complement surgical treatment for trigeminal neuralgia via direct injection of the trigeminal nerve with glycerin in the cisternal portion of the nerve. PATIENTS AND METHODS: We performed a retrospective analysis of patients who received standard microvascular decompression and injection of glycerin to the inferior third of the cisternal portion of the nerve anterior to the root entry zone with lack of a compressive vessel on MRI as the primary indication. Fourteen patients were identified and demographic information, post-operative course and complications were recorded. RESULTS: There were eleven females and three males with an average age at time of surgery of 54.8 years. 100% of patients reported that their trigeminal pain was significantly improved following surgical intervention. Four out of fourteen patients reported a 50-80% decrease from the pre-surgery baseline pain at one month and three month follow up. One patient developed a CSF leak, and no surgical site infections or motor deficits were observed. CONCLUSION: Intra-operative glycerin rhizotomy in conjunction with microvascular decompression can be used to safely treat patients suffering from trigeminal neuralgia.

Full Text

Duke Authors

Cited Authors

  • Goodwin, CR; Yang, JX; Bettegowda, C; Hwang, B; James, C; Biser, A; Raza, S; Bender, M; Carson, B; Lee, JYK; Lim, M

Published Date

  • December 2013

Published In

Volume / Issue

  • 115 / 12

Start / End Page

  • 2454 - 2456

PubMed ID

  • 24161889

Pubmed Central ID

  • 24161889

Electronic International Standard Serial Number (EISSN)

  • 1872-6968

Digital Object Identifier (DOI)

  • 10.1016/j.clineuro.2013.09.009

Language

  • eng

Conference Location

  • Netherlands