Percutaneous retrogasserian glycerol rhizolysis in the management of trigeminal neuralgia

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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.

© AANS, except where prohibited by US copyright law.

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