LONG-TERM RESULTS AFTER PERCUTANEOUS RETROGASSERIAN GLYCEROL RHIZOTOMY IN PATIENTS WITH TRIGEMINAL NEURALGIA

We have evaluated the long-term results of percutaneous retrogasserian glycerol rhizotomy (PRGR) in 60 patients with classical trigerminal n euralgia. Complete initial pain relief was achieved in 93% of the pati ents. Numbness was initially reported by 3/4 of the patients and at fo llow-up by 1/3, while long-lasting dysaesthesias were an important sid e effect in 38% of previously untreated patients. The half-life of the method was 47 months in our material, and this figure compares favour ably with other previously reported series. The method carries a signi ficant risk of long-lasting and troublesome sensory disturbances. Anot her disadvantage of the method, reported in the present long-term stud y, was the high incidence of recurrent neuralgia. We are unable to ide ntify predictors of recurrent neuralgia after PRGR, although major rec urrences were more common in patients with unchanged facial sensation postoperatively. In conclusion, PRGR offers safe and reliable relief o f pain in patients with trigeminal neuralgia. In spite of the high inc idence of recurrence and of long-lasting dysaesthesias it is, in our o pinion, the method of choice in the elderly, and particularly suitable for patients at high risk.