Recurrence of Trigeminal Neuralgia in Patient's Undergoing Radiofrequency Ablation
Study Details
Study Description
Brief Summary
This study aims to find recurrence rate of the trigeminal neuralgia after patients undergo stereotactic rhizotomy by radiofrequency ablation at 80 degrees Celsius for 90 seconds under fluoroscopic guidance, a protocol that was modified from the originally described parameters for rhizotomy by John Tew, Chad J. Morgan and Andresw Grande et al. The presumption being that the higher temperature of the probe tip would lead to a more long-lasting lesion and lesser recurrence, but at the cost of more frequent sensory and motor deficits.
Condition or Disease | Intervention/Treatment | Phase |
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Study Design
Outcome Measures
Primary Outcome Measures
- Recurrence rate of trigeminal neuralgia after stereotactic rhizotomy [Recurrence within 12 months of the intervention]
Recurrence of pain in the same distribution of the trigeminal nerve branch or branches for which the stereotactic rhizotomy was originally performed
- Proportion of patients with neurological deficits after stereotactic rhizotomy [5 years]
locally deviced protocol for stereotactic rhizotomy of the involved trigeminal gangion dictates the use of higher temperature of 80 degree Celsius for 90 seconds, which translates into better pain relief and longer pain free intervals at the cost of higher percentage of sensory and motor deficits
Eligibility Criteria
Criteria
Inclusion Criteria:
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- Patients fulfilling ICHD criteria:
Recurrent paroxysms of unilateral facial pain in the distribution(s) of one or more divisions of the trigeminal nerve, with no radiation beyond, and fulfilling criteria B and C
A. Pain has all of the following characteristics:
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lasting from a fraction of a second to 2 minutes
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severe intensity
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electric shock-like, shooting, stabbing or sharp in quality B. Precipitated by innocuous stimuli within the affected trigeminal distribution C. Not better accounted for by another ICHD-3 diagnosis.
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Age: Adults of both sexes 3. MRI brain ruled out organic or structural pathologies
Exclusion Criteria:
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- Patient with concomitant co-morbid conditions like brain tumours, vascular pathologies or coagulopathies.
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Patients who had previously undergone trigeminal ganglion neurolysis with either alcohol or phenol.
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Patients who were lost to follow-up before the completion of 6-month period or had not visited back after the procedure 4. Patients on oral anticoagulants 5. Patients declared high risk or ASA 3 and above for general anaesthesia.
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Shifa Clinical Research Center
Investigators
- Study Director: Salman A. Saleem, MBBS;FCPS, Shifa Clinical Research Center
Study Documents (Full-Text)
None provided.More Information
Publications
- Elnashar A, Patel SK, Kurbanov A, Zvereva K, Keller JT, Grande AW. Comprehensive anatomy of the foramen ovale critical to percutaneous stereotactic radiofrequency rhizotomy: cadaveric study of dry skulls. J Neurosurg. 2019 Apr 19;132(5):1414-1422. doi: 10.3171/2019.1.JNS18899.
- Kao CH, Lee MH, Yang JT, Tsai YH, Lin MH. Percutaneous Radiofrequency Rhizotomy Is Equally Effective for Trigeminal Neuralgia Patients with or Without Neurovascular Compression. Pain Med. 2022 Apr 8;23(4):807-814. doi: 10.1093/pm/pnab221.
- Rashid A, Pintea B, Kinfe TM, Surber G, Hamm K, Boström JP. LINAC stereotactic radiosurgery for trigeminal neuralgia -retrospective two-institutional examination of treatment outcomes. Radiat Oncol. 2018 Aug 22;13(1):153. doi: 10.1186/s13014-018-1102-2.
- Taha JM, Tew JM Jr, Buncher CR. A prospective 15-year follow up of 154 consecutive patients with trigeminal neuralgia treated by percutaneous stereotactic radiofrequency thermal rhizotomy. J Neurosurg. 1995 Dec;83(6):989-93.
- Zhao G, Sun X, Zhang Z, Yang H, Zheng X, Feng B. Clinical efficacy of MVD combined with PSR in the treatment of primary trigeminal neuralgia. Exp Ther Med. 2020 Aug;20(2):1582-1588. doi: 10.3892/etm.2020.8871. Epub 2020 Jun 10.
- ShifaCRC