2025 Poster Presentations
P119: IDIOPATHIC TRIGEMINAL NEURALGIA : VARIOUS MODALITIES OF TREATMENT AND ITS LONG TERM OUTCOMES
Prabu Raj Andiperumal Raj; Nupur Pruthi; NIMHANS
Introduction: Common surgical treatments for trigeminal neuralgia (TN) include microvascular decompression (MVD), stereotactic radiosurgery (SRS), and radiofrequency ablation (RFA). Although the efficacy of each procedure has been described, few studies have directly compared these treatment modalities on pain control for TN. Study is to compare long term effects of these modalities in terms of pain free period and recurrences of pain.
Methods: Retrospective analysis of all cases undergoing MVD, GKRS(Gamma knife Radiosurgery), and RFA between 2007 to 2018. Patients who have five years follow up alone included in study. All demographics details and pain relief after procedure is taken to account.
Results: Median follow up duration was 84 months for microvascular group. 58(87.8%) had a favourable outcome. 95.4% had immediate pain relief, and pain free interval was 69 months.14.2% had recurrence of pain with mean time for recurrence is 36 months. In RFA group 184 patients, 80.5% had immediate pain relief. Recurrence of pain found in 60% of patients with mean time of recurrence was 12 months. In GKRS group 52 patients was followed with mean follow up period of 100 months. 35(67.5%) had favourable outcome. Median pain free interval was 59 months. 27(51.9%) had first time GKRS as primary treatment had 78% favourable outcome.
Conclusion: In this study, patients who underwent MVD had longer pain-free intervals compared with those who underwent GKRS or RFA. Surgical decision making depends upon many factors. This information can help surgeons counsel patients with idiopathic Trigeminal neuralgia on treatment selection.