A prospective, longitudinal study on patients with trigeminal neuralgia who underwent radiofrequency thermocoagulation of the Gasserian ganglion

Outcome after radiofrequency thermocoagulation in patients with trigeminal neuralgia was assessed in a prospective, longitudinal study. Forty-eight co nsecutive patients with chronic facial pain presenting for surgery to a neu rosurgeon were studied. Patients were assessed preoperatively by an indepen dent clinician both clinically, and with the use of two questionnaires: the McGill Pain Questionnaire (MPQ) and the Hospital Anxiety and Depression (H AD) scale. From these assessments, two groups of patients were identified: 31 with pure trigeminal neuralgia (TN group) and 17 with trigeminal neuralg ia together with atypical facial pain and mixed trigeminal neuralgia (MTN g roup). All underwent radiofrequency thermocoagulation at the level of the G asserian ganglion. Patients were reviewed by the same clinician 3 months la ter and then followed up by a self-administered questionnaire at 6 months, 1 year, 2 years and 3 years. The mean follow-up time was 30 +/- 12 months. The mean time to recurrence of pain was 40 months for the TN group and 36 m onths for the MTN group. Depression and anxiety dropped more significantly post-operatively in the TN,group than the MTN group. TN group were more sat isfied with their outcome, complained of fewer complications and were more willing to have repeat surgery if necessary than patients in MTN group. The number and severity of complications varied at different time points. Care ful selection of patients for surgery using objective assessments will decr ease morbidity and improve satisfaction. Physical morbidity and recurrence rates are insufficient to gauge outcomes. Psychological, sociological and p atients' views must be included in evaluations. (C) 1999 International Asso ciation for the Study of Pain. Published by Elsevier Science B.V.