Percutaneous balloon compression of the trigeminal nerve.

Balloon compression is a simple and effective percutaneous approach for the treatment of classic trigeminal neuralgia or trigeminal neuralgia secondary to multiple sclerosis. The operation injures large myelinated fibers, removing the "trigger" to the presumed ephaptic transmission of pain. Because unmyelinated fibers, which mediate the corneal reflex, are preserved, compression may be of advantage in the treatment of first division pain, since the corneal reflex is mediated by the small unmyelinated fibers. In the author's series of 141 consecutive patients treated by balloon compression, overall recurrence rate was 26%, with 80% of patients experiencing mild numbness postoperatively.