Percutaneous procedures for trigeminal neuralgia: microcompression versus radiofrequency thermocoagulation. Personal experience.

This paper reports the results achieved in the treatment of trigeminal neuralgia using two different percutaneous procedures: radiofrequency (RF) thermocoagulation (33 patients) and the new percutaneous microcompression (PMC; 74 patients) of the trigeminal ganglion. Acute pain relief was accomplished in 93.2% of the patients treated with PMC and in 81.8% of those treated with the RF method. Two years after the operation, neuralgia had recurred in 56% of the PMC patients and in 42.4% of the RF patients. The average recurrence time was 6.5 months after PMC and 18.5 months after RF. Side effects were essentially of 2 kinds: marked dysaesthesia that occurred after RF lesion in 24.2% and after PMC in 6.7% of the patients, and weakness of the masticatory muscles that was fairly common after PMC, although clinically relevant in only 1 case. The procedure has the benefit of simplicity and fewer side effects. The results obtained by using different compression times in different patients indicates that the most suitable compression time is between 4 and 6 min. When pain recurred the procedure was repeated unless the pain was in the third division, in which case an RF lesion was made. If the pain recurred a second time, RF lesions were made if the pain was in the second or third division.