Objective: We studied the correlation of magnetic resonance imaging (MRI) findings with the prognosis of patients with multiple sclerosis (MS)-related trigeminal neuralgia (TN) who had undergone percutaneous balloon compression (PBC). To the best of our knowledge, no studies have previously reported on this topic. We also performed a review of pertinent studies. Methods: From a surgical series of 82 patients with TN who had undergone PBC from January 2013 to June 2017, we identified 16 patients with MS (mean age, 54.81 ± 8.51 years; mean follow-up, 38.12 ± 19.86 months). Using brain MRI, we evaluated the presence of a lesion in the trigeminal nerve root entry zone and trigeminal nuclei. With other clinical and procedure-related factors, we studied its effect on acute pain relief (pain free at hospital discharge) and pain-free survival (PFS). Results: Of the 16 patients, 15 (93.75%) reported acute pain relief; 8 patients (50.00%) experienced a recurrence of pain. At the latest follow-up visit, an excellent outcome (Barrow Neurological Institute grade 1–2) was obtained for 75% of patients and a good outcome (Barrow Neurological Institute grade 3) for 25%. No patient experienced uncontrolled pain. The presence of a pear-like balloon shape during surgery (P = 0.0053) and a MRI detectable lesion in the trigeminal pathway (P = 0.049) were associated with greater PFS. Conclusions: PBC can be efficient in treating MS-related TN. Some factors, such as a pear-like balloon shape during surgery and evidence of a MRI-detectable lesion in the trigeminal pathway were associated with longer PFS.

Montano, N., Gaudino, S., Giordano, C., Pignotti, F., Ioannoni, E., Rapisarda, A., Olivi, A., Possible Prognostic Role of Magnetic Resonance Imaging Findings in Patients with Trigeminal Neuralgia and Multiple Sclerosis Who Underwent Percutaneous Balloon Compression: Report of Our Series and Literature Review, <<WORLD NEUROSURGERY>>, 2019; 125 (May): e575-e581. [doi:10.1016/j.wneu.2019.01.134] [http://hdl.handle.net/10807/151721]

Possible Prognostic Role of Magnetic Resonance Imaging Findings in Patients with Trigeminal Neuralgia and Multiple Sclerosis Who Underwent Percutaneous Balloon Compression: Report of Our Series and Literature Review

Montano, Nicola
;
Gaudino, Simona;Pignotti, Fabrizio;Rapisarda, Alessandro;Olivi, Alessandro
2019

Abstract

Objective: We studied the correlation of magnetic resonance imaging (MRI) findings with the prognosis of patients with multiple sclerosis (MS)-related trigeminal neuralgia (TN) who had undergone percutaneous balloon compression (PBC). To the best of our knowledge, no studies have previously reported on this topic. We also performed a review of pertinent studies. Methods: From a surgical series of 82 patients with TN who had undergone PBC from January 2013 to June 2017, we identified 16 patients with MS (mean age, 54.81 ± 8.51 years; mean follow-up, 38.12 ± 19.86 months). Using brain MRI, we evaluated the presence of a lesion in the trigeminal nerve root entry zone and trigeminal nuclei. With other clinical and procedure-related factors, we studied its effect on acute pain relief (pain free at hospital discharge) and pain-free survival (PFS). Results: Of the 16 patients, 15 (93.75%) reported acute pain relief; 8 patients (50.00%) experienced a recurrence of pain. At the latest follow-up visit, an excellent outcome (Barrow Neurological Institute grade 1–2) was obtained for 75% of patients and a good outcome (Barrow Neurological Institute grade 3) for 25%. No patient experienced uncontrolled pain. The presence of a pear-like balloon shape during surgery (P = 0.0053) and a MRI detectable lesion in the trigeminal pathway (P = 0.049) were associated with greater PFS. Conclusions: PBC can be efficient in treating MS-related TN. Some factors, such as a pear-like balloon shape during surgery and evidence of a MRI-detectable lesion in the trigeminal pathway were associated with longer PFS.
2019
Inglese
Montano, N., Gaudino, S., Giordano, C., Pignotti, F., Ioannoni, E., Rapisarda, A., Olivi, A., Possible Prognostic Role of Magnetic Resonance Imaging Findings in Patients with Trigeminal Neuralgia and Multiple Sclerosis Who Underwent Percutaneous Balloon Compression: Report of Our Series and Literature Review, <<WORLD NEUROSURGERY>>, 2019; 125 (May): e575-e581. [doi:10.1016/j.wneu.2019.01.134] [http://hdl.handle.net/10807/151721]
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