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Neurosurgery for trigeminal neuralgia: comparison of alcohol block, neurectomy, and radiofrequency coagulation.

The Clinical journal of pain · 1996 · Unclear · Low evidence

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UnclearLow evidencePaper 4213

Among respondents, 83% (radiofrequency coagulation), 51% (neurectomy), and 42% (alcohol block) reported a pain-free postoperative period; among those, pain recurred in 49%, 78%, and 84%, respectively. At follow-up, 49% (radiofrequency coagulation), 17% (neure…

Study snapshot

PublicationThe Clinical journal of pain · 1996
Study typecohort
Reported directionUnclear
Evidence ratingLow

Abstract

OBJECTIVES: We wished to assess the present condition of patients previously treated with a neurosurgical procedure or procedures for trigeminal neuralgia (TN) in 383 patients treated between 1976 and 1991, for TN at the Department of Neurosurgery, Hvidovre Hospital. Of these, 67 were lost to follow-up. The latest surgical intervention performed was radiofrequency coagulation (RFC) (64%), neurectomy (18%), alcohol block (16%), trigeminal tractotomy (1%), and microvascular decompression (1%); 72% of patients underwent only one neurosurgical procedure. METHODS: Questionnaires were sent to 316 patients treated neurosurgically for TN during the 16-year period; 288 (91%) patients responded. The follow-up period varied from 1 to 16 years (mean 8 years). Outcome measures were effect of RFC, neurectomy, and alcohol block; present pain conditions; and sequelae. RESULTS: After RFC, neurectomy, and alcohol block, 83, 51, and 42% of patients, respectively, experienced a pain-free postoperative period; 49, 78, and 84% of these patients had recurrence of pain. At present, 49, 17, and 18% are pain-free and 33, 21, and 36% now have less pain than they did preoperatively. Temporary or permanent analgesics for facial pain were required in 41, 72, and 69% of the patients. Sequelae were described by 65, 57, and 49% of the patients. The four most common sequelae were hypoesthesia, paresthesia, eye complaints, and dysesthesia. CONCLUSION: If relevant pharmacotherapy has been tried without benefit, RFC may still be considered as a treatment for TN.

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typecohort
Effect directionunclear
PopulationPatients with trigeminal neuralgia treated at the Department of Neurosurgery, Hvidovre Hospital (treated 1976–1991)
Sample size288
ExposureFollow-up 1–16 years (mean 8 years)
Evidence strengthLowConfidence: 74% · Peer reviewed: yes

Main findings

Among respondents, 83% (radiofrequency coagulation), 51% (neurectomy), and 42% (alcohol block) reported a pain-free postoperative period; among those, pain recurred in 49%, 78%, and 84%, respectively. At follow-up, 49% (radiofrequency coagulation), 17% (neurectomy), and 18% (alcohol block) were pain-free; 33%, 21%, and 36% reported less pain than preoperatively. Sequelae were reported by 65%, 57%, and 49% of patients, respectively.

Outcomes measured

  • Pain-free postoperative period
  • Pain recurrence
  • Current pain status (pain-free; less pain than preoperative)
  • Use of analgesics for facial pain
  • Sequelae (hypoesthesia, paresthesia, eye complaints, dysesthesia)

Limitations

  • Observational follow-up based on questionnaires (self-reported outcomes)
  • 67 patients lost to follow-up from the original treated cohort
  • Treatments were not randomized; potential selection/confounding across procedure groups
  • Multiple procedures in some patients (only 72% had one procedure)
View raw extracted JSON
{
  "study_type": "cohort",
  "exposure": {
    "band": null,
    "source": null,
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": "Follow-up 1–16 years (mean 8 years)"
  },
  "population": "Patients with trigeminal neuralgia treated at the Department of Neurosurgery, Hvidovre Hospital (treated 1976–1991)",
  "sample_size": 288,
  "outcomes": [
    "Pain-free postoperative period",
    "Pain recurrence",
    "Current pain status (pain-free; less pain than preoperative)",
    "Use of analgesics for facial pain",
    "Sequelae (hypoesthesia, paresthesia, eye complaints, dysesthesia)"
  ],
  "main_findings": "Among respondents, 83% (radiofrequency coagulation), 51% (neurectomy), and 42% (alcohol block) reported a pain-free postoperative period; among those, pain recurred in 49%, 78%, and 84%, respectively. At follow-up, 49% (radiofrequency coagulation), 17% (neurectomy), and 18% (alcohol block) were pain-free; 33%, 21%, and 36% reported less pain than preoperatively. Sequelae were reported by 65%, 57%, and 49% of patients, respectively.",
  "effect_direction": "unclear",
  "limitations": [
    "Observational follow-up based on questionnaires (self-reported outcomes)",
    "67 patients lost to follow-up from the original treated cohort",
    "Treatments were not randomized; potential selection/confounding across procedure groups",
    "Multiple procedures in some patients (only 72% had one procedure)"
  ],
  "evidence_strength": "low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "trigeminal neuralgia",
    "radiofrequency coagulation",
    "neurectomy",
    "alcohol block",
    "pain recurrence",
    "sequelae",
    "questionnaire follow-up"
  ],
  "suggested_hubs": []
}
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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1097/00002508-199612000-00010
PubMed: 8969876

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