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Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia

BACKGROUND: 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. AIM: This prospective study was designed to assess the outcome of microvascular decompression (MVD) in patie...

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Autores principales: Salama, Hassan, Ben-Khayal, Hesham, Mohamed, Mohamed Abdel Salam, El-Mitwalli, Ashraf, Zaher, Ashraf Ahmed, EzzEldin, Ashraf, Badr, Hatem, Vorkapic, Peter
Formato: Texto
Lenguaje:English
Publicado: Medknow Publications 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824934/
https://www.ncbi.nlm.nih.gov/pubmed/20174498
http://dx.doi.org/10.4103/0972-2327.56317
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author Salama, Hassan
Ben-Khayal, Hesham
Mohamed, Mohamed Abdel Salam
El-Mitwalli, Ashraf
Zaher, Ashraf Ahmed
EzzEldin, Ashraf
Badr, Hatem
Vorkapic, Peter
author_facet Salama, Hassan
Ben-Khayal, Hesham
Mohamed, Mohamed Abdel Salam
El-Mitwalli, Ashraf
Zaher, Ashraf Ahmed
EzzEldin, Ashraf
Badr, Hatem
Vorkapic, Peter
author_sort Salama, Hassan
collection PubMed
description BACKGROUND: 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. AIM: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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.
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spelling pubmed-28249342010-02-21 Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia Salama, Hassan Ben-Khayal, Hesham Mohamed, Mohamed Abdel Salam El-Mitwalli, Ashraf Zaher, Ashraf Ahmed EzzEldin, Ashraf Badr, Hatem Vorkapic, Peter Ann Indian Acad Neurol Original Article BACKGROUND: 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. AIM: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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. Medknow Publications 2009 /pmc/articles/PMC2824934/ /pubmed/20174498 http://dx.doi.org/10.4103/0972-2327.56317 Text en © Annals of Indian Academy of Neurology http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Salama, Hassan
Ben-Khayal, Hesham
Mohamed, Mohamed Abdel Salam
El-Mitwalli, Ashraf
Zaher, Ashraf Ahmed
EzzEldin, Ashraf
Badr, Hatem
Vorkapic, Peter
Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia
title Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia
title_full Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia
title_fullStr Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia
title_full_unstemmed Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia
title_short Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia
title_sort outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824934/
https://www.ncbi.nlm.nih.gov/pubmed/20174498
http://dx.doi.org/10.4103/0972-2327.56317
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