Efficacy of Internal Neurolysis for Trigeminal Neuralgia without Vascular Compression

J Neurol Surg A Cent Eur Neurosurg. 2021 Jul;82(4):364-368. doi: 10.1055/s-0041-1723809. Epub 2021 Apr 12.

Abstract

Background and objective: Trigeminal neuralgia is a common neurologic disease that seriously impacts a patient's quality of life. We retrospectively investigated the efficacy and safety of internal neurolysis (nerve combing) for trigeminal neuralgia without vascular compression.

Patients and methods: This study was a retrospective review of all patients with trigeminal neuralgia who were admitted between January 2014 and February 2019. A subgroup of 36 patients had no vascular compression at surgery and underwent internal neurolysis. Chart review and postoperative follow-up were performed to assess the overall outcomes of internal neurolysis.

Results: Thirty-six patients were identified, with a mean age of 44.89 ± 7.90 (rang: 31-65) years and a disease duration of 5.19 ± 2.61 years. The immediate postoperative pain relief (Barrow Neurological Institute [BNI] pain score of I or II) rate was 100%. The medium- to long-term pain relief rate was 91.7%. Three patients experienced recurrence. Facial numbness was the primary postoperative complication. Four patients with a score of III on the BNI numbness scale immediately after surgery had marked improvement at 6 months. No serious complications occurred.

Conclusion: Internal neurolysis is a safe and effective treatment for trigeminal neuralgia without vascular compression or clear responsible vessels.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Humans
  • Hypesthesia / epidemiology*
  • Male
  • Middle Aged
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / methods*
  • Pain, Postoperative / epidemiology*
  • Quality of Life
  • Recurrence
  • Trigeminal Neuralgia / surgery*