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

Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia


Hassan Salama1, Hesham Ben-Khayal3, Mohamed Abdel Salam Mohamed3, Ashraf El-Mitwalli3, Ashraf Ahmed Zaher3, Ashraf EzzEldin2, Hatem Badr2, Peter Vorkapic3 
1 Department of Neurology and Neurosurgery, Sebea Hospital, Tripoli, Libya; Department of Neurology, Mansoura University, Egypt
2 Department of Neurosurgery, Mansoura University,Germany
3 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

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«SQ» 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«SQ» 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.


How to cite this article:
Salama H, Ben-Khayal H, Mohamed MS, El-Mitwalli A, Zaher AA, EzzEldin A, Badr H, Vorkapic P. Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia.Ann Indian Acad Neurol 2009;12:173-178


How to cite this URL:
Salama H, Ben-Khayal H, Mohamed MS, El-Mitwalli A, Zaher AA, EzzEldin A, Badr H, Vorkapic P. Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia. Ann Indian Acad Neurol [serial online] 2009 [cited 2019 Aug 25 ];12:173-178
Available from: http://www.annalsofian.org/article.asp?issn=0972-2327;year=2009;volume=12;issue=3;spage=173;epage=178;aulast=Salama;type=0