Trigeminal Neuralgia – Those With Constant Pain Component Do Poorly

There are two versions of Trigeminal Neuralgia – one version that just has episodic sharp pains, and another that has that and also a continuous pain component. Those with a continuous component do poorly.

Acta Neurochir (Wien). 2010 Oct 16. [Epub ahead of print]
Surgical treatment of trigeminal neuralgia. Results from the use of glycerol
injection, microvascular decompression, and rhizotomia.
Degn J, Brennum J.   abstract here

  • Classified TN into:
    • Type 1 – sharp lancinating episodic pain – 69%
    • Type 2 – above plus a constant burning, dull background pain – 31%
  • IN 1/5 of cases epilepsy drugs do not work and other procedures need to be considered. These include Trigeminal glycerin injection,  Microvascular decompression, and Trigeminal thermocoagulation.
  • In Trigeminal Glycerin injection, type did not make a difference – but whether or not paresthesias – numb funny feeling(Hypo group) occurred subsequently:

Either way, long term results don’t look that great.

For radiofrequency denaturation and microvascular decompresssion, TN type was significant:

For type 2 TN, both procedures faired poorly in long term – certainly the radiofrequency would not be even worth considering for type 2 TN. Type 1s do well with either radiofrequency or microvascular decompression.

Comment – this suggests the pathological basis of type 2 TN might be distinct  – this needs work. For type 2, it looks like one could start with trigeminal glycerin injection and pray for numb paresthesias…

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One Response to Trigeminal Neuralgia – Those With Constant Pain Component Do Poorly

  1. Mary says:

    Your information on this site is great and I look forward to your posts however i feel your last comment “and pray for numb paresthesias” rather thoughtless. I have type 2 TN and the medications have now stopped giving me relief as this disease grows stronger and more frequent. The neurosurgon won’t operate and my neurologist says he can no longer help me. I have tried every treatment I can find on the internet. My attacks last from 6 weeks to 5 months and I usually get 3-4 weeks in between with no pain. I am now in my third week of another attack and I ask myself every day if it is really worthwhile living like this.
    My whole blog is meant to offer options for people like you, Recent article by Dr.Moulin found only 1/4 people with neuropathic pain reach pain control. My first blog note about reaching critical mass goes over options. Type 2 Trigeminal neuralgia is more like the constant burning pain with jabs on top.

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