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

Nicola Montano, Simona Gaudino, Carolina Giordano, Fabrizio Pignotti, Eleonora Ioannoni, Alessandro Rapisarda, Alessandro Olivi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)e575-e581
JournalWorld Neurosurg.
Volume125
DOIs
Publication statusPublished - May 2019

Keywords

  • Adult
  • Aged
  • Balloon Occlusion/methods
  • Female
  • Humans
  • Magnetic Resonance Imaging/methods
  • Male
  • Middle Aged
  • Multiple Sclerosis/complications
  • Pain/diagnosis
  • Pain Management
  • Prognosis
  • Retrospective Studies
  • Trigeminal Nerve/surgery
  • Trigeminal Neuralgia/complications

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