Abstract
Objective: We studied the correlation of magnetic resonance imaging (MRI) findings with the prognosis of patients with multiple sclerosis (MS)-related trigeminal neuralgia (TN) who had undergone percutaneous balloon compression (PBC). To the best of our knowledge, no studies have previously reported on this topic. We also performed a review of pertinent studies. Methods: From a surgical series of 82 patients with TN who had undergone PBC from January 2013 to June 2017, we identified 16 patients with MS (mean age, 54.81 ± 8.51 years; mean follow-up, 38.12 ± 19.86 months). Using brain MRI, we evaluated the presence of a lesion in the trigeminal nerve root entry zone and trigeminal nuclei. With other clinical and procedure-related factors, we studied its effect on acute pain relief (pain free at hospital discharge) and pain-free survival (PFS). Results: Of the 16 patients, 15 (93.75%) reported acute pain relief; 8 patients (50.00%) experienced a recurrence of pain. At the latest follow-up visit, an excellent outcome (Barrow Neurological Institute grade 1–2) was obtained for 75% of patients and a good outcome (Barrow Neurological Institute grade 3) for 25%. No patient experienced uncontrolled pain. The presence of a pear-like balloon shape during surgery (P = 0.0053) and a MRI detectable lesion in the trigeminal pathway (P = 0.049) were associated with greater PFS. Conclusions: PBC can be efficient in treating MS-related TN. Some factors, such as a pear-like balloon shape during surgery and evidence of a MRI-detectable lesion in the trigeminal pathway were associated with longer PFS.
Lingua originale | English |
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pagine (da-a) | e575-e581 |
Rivista | World Neurosurgery |
Volume | 125 |
DOI | |
Stato di pubblicazione | Pubblicato - 2019 |
Keywords
- Adult
- Aged
- Balloon Occlusion
- Female
- Humans
- Magnetic Resonance Imaging
- Magnetic resonance imaging
- Male
- Middle Aged
- Multiple Sclerosis
- Multiple sclerosis
- Pain
- Pain Management
- Percutaneous balloon compression
- Prognosis
- Retrospective Studies
- Trigeminal Nerve
- Trigeminal Neuralgia
- Trigeminal neuralgia