G. Gronseth, MD, FAAN,
G. Cruccu, MD,
J. Alksne, MD,
C. Argoff, MD,
M. Brainin, MD, FESO,
K. Burchiel, MD,
T. Nurmikko, MD, PhD and
J. M. Zakrzewska, MD, FDSRCS, FFDRCSI
From the Department of Neurology (G.G.), University of Kansas, Kansas City; Department of Neurological Sciences (G.C.), La Sapienza University, Rome, Italy; Division of Neurosurgery (J.A.), School of Medicine, University of California, San Diego; Albany Medical College and Albany Medical Center (C.A.), Albany, NY; Clinical Neurosciences (M.B.), Department of Clinical Medicine and Prevention, Donau-Universität Krems, Krems, Austria; Department of Neurological Surgery (K.B.), Oregon Health & Science University, Portland; Pain Research Institute (T.N.), Division of Neurological Science, School of Clinical Sciences, University of Liverpool, UK; and University College London Hospital Eastman Dental Hospital (J.M.Z.), UK.
Figure 1 Mean age and relative frequency of clinical characteristics and abnormal trigeminal reflexes in classic (CTN) and symptomatic trigeminal neuralgia (STN)
Response to treatment and involvement of first trigeminal division are similar in the two populations. Onset age is lower in CTN than STN (p < 0.0001). Bilateral neuralgia and sensory deficits only occur in STN (p < 0.001). Trigeminal reflexes (TR) are abnormal in STN (87%) and normal in CTN (94%) (p < 0.0001). Data from 10 trials (Class I–III) in 628 patients, detailed in tables e-2 and e-3. *p < 0.001; **p < 0.0001.
Frequency (%) of complications with surgical procedures for trigeminal neuralgia. PGL = percutaneous Gasserian lesions (includes radiofrequency thermocoagulation, glycerol rhizotomy, balloon compression); MVD = microvascular decompression; GKS = Gamma knife surgery. Perioperative complications: pneumonia and deep vein thrombosis. Data from 14 trials (Class III) in 2,785 operated patients, detailed in table e-9. *Many Class IV studies on GKS report trigeminal sensory disturbances in 9–37% of patients.
