Prognostic factors and effectiveness of percutaneous balloon compression in the treatment of trigeminal neuralgia: An experience of 222 patients

The American Academy of Neurology (AAN) 70th Annual MeetingNNM Neto, SAF Dantas, JJ da Silva, DD Rolim, MR Zacarkim, JT da S Maia | April 23, 2018

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Summary: In this retrospective study, researchers assessed the efficacy of percutaneous balloon compression (PBC)--a therapeutic treatment option for trigeminal neuralgia (TN), and factors that may have influenced outcomes. They concluded that PBC should be considered the primary surgical reatment for TN, as it was effective, safe, and provided high rates of pain relief (93.7%) in the following 6 months after surgery. In addition, PBC significantly reduced the use of carbamazepine in these patients, and relapse was rare. Complications were minor and transitory. Finally, they found that balloon shape and hypoesthesia had a positve effect on pain relief.

Methods:

  • Researchers retrospectively reviewed records from 222 patients (mean age: 62 years; 43% male) who underwent 242 procedures of PBC as treatment for TN.
  • Five patients manifested rare cases of bilateral TN.

Results:

  • Immediately after surgery, 79.7% of patients became pain-free and 14% patients became pain free within the following 4 days.
  • In 93.7% of patients, treatment with carbamazepine was suspended.
  • At follow-up, only 5.37% of patients reported any residual pain.
  • Hypoesthesia was reported after 83.8% of procedures, and bradycardia occurred in 58.1% of cases during foramen ovale puncture.
  • Transitory complications including diplopia (2.47%), otalgia (1.23%) and tinnitus (1.23%) were reported.
  • For balloon appearance, pear and dumb-bell shapes were detected in 74.8% and 7.4% of procedures, respectively.
  • Reoperation due to the persistence of pain was necessary in only 6.19%.

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