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NEW YORK, Mar 14 (Reuters Health) - People with the stabbing facial pain known as trigeminal neuralgia may get long-term relief from a minimally-invasive procedure in which the nerve is damaged with a heat-generating electrode, researchers report.
The condition occurs in the trigeminal nerve, which affects perceptions of touch, pain and temperature in the face and jaw. People with trigeminal neuralgia experience shock-like or stabbing facial pain that may be triggered by everyday motions such as talking, tooth brushing or chewing. Drug treatment can often quell the pain, but some patients require surgery to relieve pressure on the nerve from surrounding blood vessels.
In the new study, researchers in Turkey looked at the effectiveness of radiofrequency trigeminal rhizotomy, a procedure in which a needle is inserted near the nerve and a radiofrequency-producing electrode generates heat to make lesions on the nerve.
Looking at 1,600 patients, Dr. Yucel Kanpolat and his colleagues at Ankara University School of Medicine found that although one quarter of the patients needed at least one repeat procedure, 92% said their pain had faded 5 years after the initial treatment. And more than half found complete pain relief after one procedure, according to a report in the March issue of Neurosurgery.
The researchers note that they have used this method for more than 25 years, and the procedure requires considerable experience and judgment in finding the affected branch of the trigeminal nerve. And side effects do occur. In this study, some patients had complications such as weakness or paralysis in facial muscles and inflammation in the cornea.
Still, the tactic of using radio waves to destroy part of the nerve "has stood the test of time as an effective treatment for this problem," Dr. Ronald I. Apfelbaum of Salt Lake City, Utah, writes in a commentary published with the report.
The complications, he notes, "always will be a down side to the procedure."
SOURCE: Neurosurgery 2001;48:524-534.
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