Annals of Indian Academy of Neurology
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ORIGINAL ARTICLE
Year : 2009  |  Volume : 12  |  Issue : 3  |  Page : 173-178

Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia


1 Department of Neurology and Neurosurgery, Sebea Hospital, Tripoli, Libya; Department of Neurology, Mansoura University, Egypt
2 Department of Neurology and Neurosurgery, Sebea Hospital, Tripoli, Libya
3 Department of Neurology, Mansoura University, Egypt
4 Department of Neurosurgery, Mansoura University,Germany
5 Department of Neurology and Neurosurgery, Sebea Hospital, Tripoli, Libya; Department of Neurosurgery, Hanover University, Germany

Correspondence Address:
Hassan Salama
Department of Neurology, Mansoura University, Egypt

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.56317

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Background: The neurovascular conflict in trigeminal neuralgia is an intractable condition; medical treatment is usually of long duration and can be annoying for both patients and clinicians. Aim: This prospective study was designed to assess the outcome of microvascular decompression (MVD) in patients with more than 3 years' history of intractable idiopathic trigeminal neuralgia (TN) and poor response to drugs. Materials and Methods: Twenty-one patients (8 females and 13 males) with intractable idiopathic TN (group 1) underwent MVD and were followed up for 2 years. Group 2 (n = 15), which included 6 females and 9 males, received pharmacotherapy. The outcome responses of pain relief were evaluated using a 10-cm visual analog scale (VAS) and the Barrow Neurological Institute (BNI) scoring system. The patients' morbidity was recorded as well.Results: All patients fulfilling the inclusion criteria were offered MVD surgery. Freedom from pain was achieved immediately after surgery in 95.2% (n = 20) of patients in group 1, and 90.5% (n = 19) had sustained relief over the follow-up period. There were no statistical significance recurrences or surgical complications in group 1 (P>0.5), while 53.3% (n = 8) of the subjects in group 2 showed poor response with pharmacotherapy over the same period of time and many patients experienced drug intolerance that had statistical significance (P<0.01). Conclusion: Early MVD in TN can help patients avoid the side effects of drugs and the adverse psychological effects of long-term pharmacotherapy and prolonged morbidity.


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