Gündüz Hasan Burak, Kurşun Abdullah Safa, Ekşi Fatih, Öztürk Fikret, Karataş Okumuş Seda Yağmur, Tütüncü Mesude, Soysal Aysun, Emel Erhan
Neurological Surgery, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric Neurological Diseases, İstanbul, TUR.
Neurological Surgery, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Neurology, Neurosurgery and Psychiatry, İstanbul, TUR.
Cureus. 2023 Sep 6;15(9):e44810. doi: 10.7759/cureus.44810. eCollection 2023 Sep.
Aim The aim of this study was to investigate possible differences (in terms of demographic structure, disease history, complaints, clinical findings, early and late treatment outcomes, and complications) between patients with idiopathic trigeminal neuralgia (ITN) and trigeminal neuralgia (TN) secondary to multiple sclerosis (MS) who were admitted to our clinic and underwent radiofrequency (RF) thermocoagulation procedure. Materials and methods Patients who underwent percutaneous radiofrequency thermocoagulation with a diagnosis of trigeminal neuralgia by a single neurosurgeon in a single neurosurgery clinic between January 2005 and January 2020 were included in this study. Patients were divided into two groups: idiopathic trigeminal neuralgia and trigeminal neuralgia secondary to multiple sclerosis (MSTN) according to their diagnosis. In our study, 215 TN patients who underwent 286 procedures were included. These patients were categorized according to age, sex, involved side, pain localization, and pain history. Postoperative complications were determined after each intervention. The early and late results of all interventions were evaluated, and the results were compared between both groups. All results were statistically analyzed. Results Considering the age of the patients, the mean age of the idiopathic group was higher than the multiple sclerosis group (58.18>49.46). In terms of the side of pain, bilateral involvement was significantly more common in the MS secondary group (1.48%<30.77%). There was no significant difference between the early results of both groups. In terms of remission periods, the pain-free period in the MS secondary group was significantly shorter than in the idiopathic group (mean value in months, 30.87>23.81). Conclusion The radiofrequency thermocoagulation of the trigeminal nerve is a highly effective, low-complication, reproducible procedure for trigeminal neuralgia, but the search for ways to improve the efficacy of treatment in MS patients should continue.
目的 本研究旨在调查因原发性三叉神经痛(ITN)和继发于多发性硬化(MS)的三叉神经痛(TN)而入住我院并接受射频(RF)热凝治疗的患者之间可能存在的差异(在人口结构、疾病史、主诉、临床发现、早期和晚期治疗结果以及并发症方面)。
材料与方法 本研究纳入了2005年1月至2020年1月期间在单一神经外科诊所由单一神经外科医生诊断为三叉神经痛并接受经皮射频热凝治疗的患者。根据诊断结果,患者被分为两组:原发性三叉神经痛组和继发于多发性硬化的三叉神经痛组(MSTN)。本研究纳入了215例接受了286次手术的TN患者。这些患者根据年龄、性别、受累侧、疼痛部位和疼痛史进行分类。每次干预后确定术后并发症。评估所有干预的早期和晚期结果,并在两组之间比较结果。所有结果均进行统计学分析。
结果 考虑患者年龄,原发性组的平均年龄高于多发性硬化组(58.18>49.46)。在疼痛侧方面,继发于MS的组中双侧受累明显更常见(1.48%<30.77%)。两组的早期结果无显著差异。在缓解期方面,继发于MS的组的无痛期明显短于原发性组(以月为单位的平均值,30.87>23.81)。
结论 三叉神经射频热凝术是一种治疗三叉神经痛高效、低并发症且可重复的方法,但仍应继续探索提高MS患者治疗效果的方法。