Abstract

Background: Trigeminal neuralgia (TN) is a unique disease. The first line of management in TN is medical treatment using antiepileptic drugs, when drugs failed to control the pain or when there is intolerability to them, surgical interventions are then indicated. Percutaneous Trigeminal rhizotomy (PTR) is recommended for elderly patients with higher operative risk factors. Objective: The aim of this work is to review the literature regarding the pathology, methods of investigations, operative techniques, complications of management of trigeminal neuralgia and eventually prognosis, also evaluation of the effectiveness of the radiofrequency percutaneous radiofrequency rhizotomy - for management of trigeminal neuralgia. Patients and Methods: This study included a total of 15 patients with trigeminal neuralgia presented predominantly in females. Female: male 1.7:1 and the mean age was 53 years. They were admitted and managed at the Neurosurgical Department of at Al-Azhar University Hospitals and other private centers between June 2017 and October 2018. Clinical follow-up was obtained in 15 (100%) patients. Results: follow up revealed that 11 patient (73.4 %) had favorable outcome and 4 patient (26.6%) had unfavorable outcome. The mean preoperative visual analogue scale(VAS) was 7.83 (range 7-10). It dropped immediately postoperative to 2.33 (range 1- 4).), intraoperative complication was noted in 3 cases (18%).Conclusion: Radiofrequency rhizotomy is the procedure of choice for most patients undergoing first surgical treatments and patients at high risk from general anesthesia (although not necessarily the elderly).

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