Possible Prognostic Role of Magnetic Resonance Imaging Findings in Patients with Trigeminal Neuralgia and Multiple Sclerosis Who Underwent Percutaneous Balloon Compression: Report of Our Series and Literature Review

Nicola Montano*, Simona Gaudino, Carolina Giordano, Fabrizio Pignotti, Eleonora Ioannoni, Alessandro Rapisarda, Alessandro Olivi

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo in rivista

10 Citazioni (Scopus)

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 originaleEnglish
pagine (da-a)e575-e581
RivistaWorld Neurosurgery
Volume125
DOI
Stato di pubblicazionePubblicato - 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

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