Percutaneous retrogasserian glycerol rhizolysis in the management of trigeminal neuralgia

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  • 1 Department of Neurological Surgery, University of Washington, and Veterans Administration Hospital, Seattle, Washington
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✓ Sixty patients with trigeminal neuralgia or atypical facial pain were followed for an average of 1 year after percutaneous retrogasserian glycerol rhizolysis. The procedure was initially effective in relieving pain in 80% of the patients with typical trigeminal neuralgia and symptomatic trigeminal neuralgia secondary to multiple sclerosis. However, life-table analysis indicated that 50% of this group had persistence or recurrence of pain within 18 months after the operation. Percutaneous retrogasserian glycerol rhizolysis was ineffective in relieving atypical trigeminal neuralgia or atypical facial pain. Minor complications occurred in 23% of patients, and major morbidity was seen in 1.6%. Facial sensory loss which persisted for more than 1 month was found in 72% of patients, corneal hypesthesia occurred in 15%, and an additional 7% had corneal anesthesia. The data indicate that the success of percutaneous retrogasserian glycerol rhizolysis in relieving trigeminal neuralgia is directly related to the production of facial sensory loss.

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Contributor Notes

Dr. Burchiel was the recipient of Teacher-Investigator Development Award K07 NS0802 from the National Institute of Neurological and Communicative Disorders and Stroke.

Address reprint requests to: Kim J. Burchiel, M.D., Department of Neurological Surgery, University of Washington Ri-20, Seattle, Washington 98195.
  • 1.

    Arias MJ: Percutaneous retrogasserian glycerol rhizolysis for trigeminal neuralgia. A prospective study of 100 cases. J Neurosurg 65:3236, 1986 Arias MJ: Percutaneous retrogasserian glycerol rhizolysis for trigeminal neuralgia. A prospective study of 100 cases. J Neurosurg 65:32–36, 1986

    • Search Google Scholar
    • Export Citation
  • 2.

    Beck DW, , Olson JJ, & Urig EJ: Percutaneous retrogasserian glycerol rhizolysis for treatment of trigeminal neuralgia. J Neurosurg 65:2831, 1986 Beck DW, Olson JJ, Urig EJ: Percutaneous retrogasserian glycerol rhizolysis for treatment of trigeminal neuralgia. J Neurosurg 65:28–31, 1986

    • Search Google Scholar
    • Export Citation
  • 3.

    Bennett MH, & Lunsford LD: Percutaneous retrogasserian glycerol rhizolysis for tic douloureux: Part 2. Results and implications of trigeminal evoked potential studies. Neurosurgery 14:431435, 1984 Bennett MH, Lunsford LD: Percutaneous retrogasserian glycerol rhizolysis for tic douloureux: Part 2. Results and implications of trigeminal evoked potential studies. Neurosurgery 14:431–435, 1984

    • Search Google Scholar
    • Export Citation
  • 4.

    Burchiel KJ: Abnormal impulse generation in focally demyelinated trigeminal roots. J Neurosurg 53:674683, 1980 Burchiel KJ: Abnormal impulse generation in focally demyelinated trigeminal roots. J Neurosurg 53:674–683, 1980

    • Search Google Scholar
    • Export Citation
  • 5.

    Burchiel KJ, & Russell LC: Glycerol neurolysis: neurophysiological effects of topical glycerol application on rat saphenous nerve. J Neurosurg 63:784788, 1985 Burchiel KJ, Russell LC: Glycerol neurolysis: neurophysiological effects of topical glycerol application on rat saphenous nerve. J Neurosurg 63:784–788, 1985

    • Search Google Scholar
    • Export Citation
  • 6.

    Dieckmann G, , Veras G, & Sogabe K: Retrogasserian glycerol injection or percutaneous stimulation in the treatment of typical and atypical trigeminal pain. Neurol Res 9:4849, 1987 Dieckmann G, Veras G, Sogabe K: Retrogasserian glycerol injection or percutaneous stimulation in the treatment of typical and atypical trigeminal pain. Neurol Res 9:48–49, 1987

    • Search Google Scholar
    • Export Citation
  • 7.

    Esposito S, , Delitala A, & Bruni P, et al: Therapeutic protocol in the treatment of trigeminal neuralgia. Appl Neurophysiol 48:271273, 1985 Esposito S, Delitala A, Bruni P, et al: Therapeutic protocol in the treatment of trigeminal neuralgia. Appl Neurophysiol 48:271–273, 1985

    • Search Google Scholar
    • Export Citation
  • 8.

    Fraioli B, , Ferrante L, & Santoro A, et al: Recent progress in the treatment of trigeminal neuralgia: glycerol into the trigeminal cistern and percutaneous gasserian compression by means of Fogarty's catheter. Acta Neurochir Suppl 33:507510, 1984 Fraioli B, Ferrante L, Santoro A, et al: Recent progress in the treatment of trigeminal neuralgia: glycerol into the trigeminal cistern and percutaneous gasserian compression by means of Fogarty's catheter. Acta Neurochir Suppl 33:507–510, 1984

    • Search Google Scholar
    • Export Citation
  • 9.

    Håkanson S: Retrogasserian glycerol injection as a treatment of tic douloureux, in Bonica JJ, , Lindblom U, & Iggo A (eds): Advances in Pain Research and Therapy, Vol 5. Raven Press: New York, 1983, pp 927933 Håkanson S: Retrogasserian glycerol injection as a treatment of tic douloureux, in Bonica JJ, Lindblom U, Iggo A (eds): Advances in Pain Research and Therapy, Vol 5. Raven Press: New York, 1983, pp 927–933

    • Search Google Scholar
    • Export Citation
  • 10.

    Håkanson S: Tic douloureux treated by the injection of glycerol into the retrogasserian subarachnoid space. Longterm results. Acta Neurochir Suppl 33:471472, 1984 Håkanson S: Tic douloureux treated by the injection of glycerol into the retrogasserian subarachnoid space. Longterm results. Acta Neurochir Suppl 33:471–472, 1984

    • Search Google Scholar
    • Export Citation
  • 11.

    Håkanson S: Transovale trigeminal cisternography. Surg Neurol 10:137144, 1978 Håkanson S: Transovale trigeminal cisternography. Surg Neurol 10:137–144, 1978

    • Search Google Scholar
    • Export Citation
  • 12.

    Håkanson S: Trigeminal neuralgia treated by the injection of glycerol into the trigeminal cistern. Neurosurgery 9:638646, 1981 Håkanson S: Trigeminal neuralgia treated by the injection of glycerol into the trigeminal cistern. Neurosurgery 9:638–646, 1981

    • Search Google Scholar
    • Export Citation
  • 13.

    Kaplan EL, & Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457481, 1958 Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481, 1958

    • Search Google Scholar
    • Export Citation
  • 14.

    Lunsford LD: Glycerol rhizotomy for trigeminal neuralgia. J Neurosurg 66:151, 1987 (Letter) Lunsford LD: Glycerol rhizotomy for trigeminal neuralgia. J Neurosurg 66:151, 1987 (Letter)

    • Search Google Scholar
    • Export Citation
  • 15.

    Lunsford LD: Treatment of tic douloureux by percutaneous retrogasserian glycerol injection. JAMA 248:449453, 1982 Lunsford LD: Treatment of tic douloureux by percutaneous retrogasserian glycerol injection. JAMA 248:449–453, 1982

    • Search Google Scholar
    • Export Citation
  • 16.

    Lunsford LD, & Bennett MH: Percutaneous retrogasserian glycerol rhizolysis for tic douloureux: Part 1. Technique and results in 112 patients. Neurosurgery 14:424430, 1984 Lunsford LD, Bennett MH: Percutaneous retrogasserian glycerol rhizolysis for tic douloureux: Part 1. Technique and results in 112 patients. Neurosurgery 14:424–430, 1984

    • Search Google Scholar
    • Export Citation
  • 17.

    Lunsford LD, , Bennett MH, & Martinez AJ: Experimental trigeminal glycerol injection. Electrophysiologic and morphologic effects. Arch Neurol 42:146149, 1985 Lunsford LD, Bennett MH, Martinez AJ: Experimental trigeminal glycerol injection. Electrophysiologic and morphologic effects. Arch Neurol 42:146–149, 1985

    • Search Google Scholar
    • Export Citation
  • 18.

    Meyerson BA: Recent advances in neurosurgical treatment of chronic pain. Acta Neurol Scand 62 (Suppl 78):1523, 1980 Meyerson BA: Recent advances in neurosurgical treatment of chronic pain. Acta Neurol Scand 62 (Suppl 78):15–23, 1980

    • Search Google Scholar
    • Export Citation
  • 19.

    Rengachary SS, , Watanabe IS, & Singer P, et al: Effect of glycerol on peripheral nerve: an experimental study. Neurosurgery 13:681688, 1983 Rengachary SS, Watanabe IS, Singer P, et al: Effect of glycerol on peripheral nerve: an experimental study. Neurosurgery 13:681–688, 1983

    • Search Google Scholar
    • Export Citation
  • 20.

    Sahni KS, , Maset A, & Young HF: Glycerol rhizotomy as treatment for trigeminal neuralgia. Va Med 114:298300, 1987 Sahni KS, Maset A, Young HF: Glycerol rhizotomy as treatment for trigeminal neuralgia. Va Med 114:298–300, 1987

    • Search Google Scholar
    • Export Citation
  • 21.

    Sweet WH: The treatment of trigeminal neuralgia (tic douloureux). N Engl J Med 315:174177, 1986 Sweet WH: The treatment of trigeminal neuralgia (tic douloureux). N Engl J Med 315:174–177, 1986

    • Search Google Scholar
    • Export Citation
  • 22.

    Sweet WH, & Poletti CE: Problems with retrogasserian glycerol in the treatment of trigeminal neuralgia. Appl Neurophysiol 48:252257, 1985 Sweet WH, Poletti CE: Problems with retrogasserian glycerol in the treatment of trigeminal neuralgia. Appl Neurophysiol 48:252–257, 1985

    • Search Google Scholar
    • Export Citation
  • 23.

    Sweet WH, , Poletti CE, & Macon JB: Treatment of trigeminal neuralgia and other facial pains by retrogasserian injection of glycerol. Neurosurgery 9:647653, 1981 Sweet WH, Poletti CE, Macon JB: Treatment of trigeminal neuralgia and other facial pains by retrogasserian injection of glycerol. Neurosurgery 9:647–653, 1981

    • Search Google Scholar
    • Export Citation
  • 24.

    Waltz TA, , Dalessio DJ, & Ott KH, et al: Trigeminal cistern glycerol injections for facial pain. Headache 25:354357, 1985 Waltz TA, Dalessio DJ, Ott KH, et al: Trigeminal cistern glycerol injections for facial pain. Headache 25:354–357, 1985

    • Search Google Scholar
    • Export Citation
  • 25.

    White JC, & Sweet WH: Pain and the Neurosurgeon: A Forty-Year Experience. Springfield, Ill: Charles C Thomas, 1969, pp 179256 White JC, Sweet WH: Pain and the Neurosurgeon: A Forty-Year Experience. Springfield, Ill: Charles C Thomas, 1969, pp 179–256

    • Search Google Scholar
    • Export Citation

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