Revisión

Treatment of trigeminal neuralgia: an update and future prospects of percutaneous techniques

A. Bescós, V. Pascual, M. Escosa-Bagé, X. Màlaga [REV NEUROL 2015;61:114-124] PMID: 26178516 DOI: https://doi.org/10.33588/rn.6103.2015098

OPEN ACCESS

Volumen 61 | Number 03 | Nº of views of the article 15.300 | Nº of PDF downloads 1.733 | Article publication date 01/08/2015

Download PDF Castellano Citation Search in PubMed

Share in:

Go to another issue

ABSTRACT

INTRODUCTION Trigeminal neuralgia is one of the most severe facial pain syndromes. The annual incidence varies between 4-13% and has a significant effect on patients’ quality of life. When the pain cannot be controlled by pharmacological treatment, several different surgical options can be considered. The choice of technique will be based on observational studies and its application depends on the experience of each centre. AIMS. To assess the effectiveness and level of evidence of pharmacological and surgical treatment in trigeminal neuralgia, and to analyse the current role of percutaneous techniques in the treatment of this pathology. DEVELOPMENT. The initial treatment of trigeminal neuralgia is pharmacological and carbamazepine is the only drug with a sufficiently high level of evidence. The percutaneous surgical techniques are effective and easy to apply, but the tendency for relapses to appear means there is a preference for vascular microdecompression. Yet, there are no reports of comparative studies that determine the superiority of a technique with a good level of evidence. The three most commonly used percutaneous techniques, balloon compression, glycerol rhizotomy and thermocoagulation by radiofrequency, were reviewed. This last technique is the one that has undergone the greatest development in recent years, with the emergence of neurophysiological techniques that make it possible to optimise results.

CONCLUSIONS The selection of a surgical technique for use in trigeminal neuralgia does not have much backing from randomised clinical trials. The new procedures in the application of radiofrequency can improve the treatment prospects of this pathology. KeywordsBalloon compression Continuous radiofrequency Glycerol Percutaneous techniques Pulsed radiofrequency Thermocoagulation Trigeminal neuralgia CategoriesDolor Técnicas exploratorias

FULL TEXT (solo disponible en lengua castellana / Only available in Spanish)

Acceso directo al último número

Último Podcast

Revisión

Treatment of trigeminal neuralgia: an update and future prospects of percutaneous techniques