Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia
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. This prospective study was designed to assess the outcome of microvascular decompression (MVD) in patients with more tha...
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| Veröffentlicht in: | Annals of the Indian Academy of Neurology 2009-07, Vol.12 (3), p.173-178 |
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| container_title | Annals of the Indian Academy of Neurology |
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| creator | Salama, Hassan Ben-Khayal, Hesham Mohamed, Mohamed Abdel Salam El-Mitwalli, Ashraf Zaher, Ashraf Ahmed Ezzeldin, Ashraf Badr, Hatem Vorkapic, Peter |
| description | 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.
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.
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.
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 |
| doi_str_mv | 10.4103/0972-2327.56317 |
| format | Article |
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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.
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.
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).
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.</description><identifier>ISSN: 0972-2327</identifier><identifier>EISSN: 1998-3549</identifier><identifier>DOI: 10.4103/0972-2327.56317</identifier><identifier>PMID: 20174498</identifier><language>eng</language><publisher>India: Medknow Publications and Media Pvt. Ltd</publisher><subject>Care and treatment ; Data collection ; Diagnosis ; Drug therapy ; Health aspects ; Hospitals ; Magnetic resonance imaging ; Medical care, Cost of ; Medical research ; Neuralgia, Trigeminal ; Original ; Patient outcomes ; Statistical analysis</subject><ispartof>Annals of the Indian Academy of Neurology, 2009-07, Vol.12 (3), p.173-178</ispartof><rights>COPYRIGHT 2009 Medknow Publications and Media Pvt. Ltd.</rights><rights>Copyright Medknow Publications & Media Pvt. Ltd. Jul 2009</rights><rights>Annals of Indian Academy of Neurology 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-1ecd56db608af1e0f2037af30d0b1be382a6e8f470195f69d55bdba273f97eaf3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824934/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824934/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20174498$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Salama, Hassan</creatorcontrib><creatorcontrib>Ben-Khayal, Hesham</creatorcontrib><creatorcontrib>Mohamed, Mohamed Abdel Salam</creatorcontrib><creatorcontrib>El-Mitwalli, Ashraf</creatorcontrib><creatorcontrib>Zaher, Ashraf Ahmed</creatorcontrib><creatorcontrib>Ezzeldin, Ashraf</creatorcontrib><creatorcontrib>Badr, Hatem</creatorcontrib><creatorcontrib>Vorkapic, Peter</creatorcontrib><title>Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia</title><title>Annals of the Indian Academy of Neurology</title><addtitle>Ann Indian Acad Neurol</addtitle><description>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.
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.
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.
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).
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.</description><subject>Care and treatment</subject><subject>Data collection</subject><subject>Diagnosis</subject><subject>Drug therapy</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Magnetic resonance imaging</subject><subject>Medical care, Cost of</subject><subject>Medical research</subject><subject>Neuralgia, Trigeminal</subject><subject>Original</subject><subject>Patient outcomes</subject><subject>Statistical analysis</subject><issn>0972-2327</issn><issn>1998-3549</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFks1rFTEUxYMotlbX7mRw42pe8zlJNkIpfkGhG124CpnMzTRlJnkmMwX_ezN99aFSkARCcn_ncnM4CL0meMcJZudYS9pSRuVOdIzIJ-iUaK1aJrh-ik6P1RP0opRbjEXHWfccnVBMJOdanaLv1-vi0gxN8s0MQ3B2amwcmrLm8f4y22hHmCEuTYh1L9m6xfYTNGEIaW-Xm-CaJYfKhFj5CGu20xjsS_TM26nAq4fzDH37-OHr5ef26vrTl8uLq9YJqpaWgBtEN_QdVtYTwJ5iJq1neMA96YEpajtQnktMtPCdHoToh95SybyWUMEz9P7Qd7_29QcOthEns89htvmnSTaYvysx3Jgx3RmqKNeM1wbvHhrk9GOFspg5FAfTZCOktRgpuJLV3O7_JONUYyU28u0_5G1ac_WnGCUwp1RzWaH2AI12AhOiT5u5I0SoY6YIPtTnC4o1k1Lrjd89wtc1VO_do4Lzg8DlVEoGf3SFYLPlx2wJMVtCzH1-quLNn2Ye-d-BYb8AQR_BJg</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Salama, Hassan</creator><creator>Ben-Khayal, Hesham</creator><creator>Mohamed, Mohamed Abdel Salam</creator><creator>El-Mitwalli, Ashraf</creator><creator>Zaher, Ashraf Ahmed</creator><creator>Ezzeldin, Ashraf</creator><creator>Badr, Hatem</creator><creator>Vorkapic, Peter</creator><general>Medknow Publications and Media Pvt. 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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.
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.
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).
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.</abstract><cop>India</cop><pub>Medknow Publications and Media Pvt. Ltd</pub><pmid>20174498</pmid><doi>10.4103/0972-2327.56317</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Annals of the Indian Academy of Neurology, 2009-07, Vol.12 (3), p.173-178 |
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| source | Medknow Open Access Medical Journals; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; PubMed Central |
| subjects | Care and treatment Data collection Diagnosis Drug therapy Health aspects Hospitals Magnetic resonance imaging Medical care, Cost of Medical research Neuralgia, Trigeminal Original Patient outcomes Statistical analysis |
| title | Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia |
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