Trigeminal neuralgia is the abbreviation of primary trigeminal neuralgia, which is a brief recurrent severe pain in the distribution area of the trigeminal nerve. It is a sudden, intense, lightning-like, brief jerking pain in the face, mouth and jaw area, like cutting, burning, stabbing or electric shock tearing pain, mostly occurring when talking, eating or washing the face, lasting for a few seconds or tens of seconds to 1~2 min each time.
Trigeminal neuralgia brings a lot of troubles and pains to patients and should be examined and treated early. Radiofrequency thermocoagulation is one of the main means of treating trigeminal neuralgia at present.
Indications for radiofrequency treatment of trigeminal neuralgia.
1, Patients with trigeminal neuralgia who have been taking larger doses of carbamazepine or phenytoin sodium for a long time.
2. Patients with trigeminal neuralgia for whom ethanol closure, glycerol injection or other surgical treatments are ineffective.
3, Patients with trigeminal neuralgia that relapsed after various surgeries.
4, Patients with recurrence of trigeminal neuralgia after radiofrequency thermal coagulation treatment can repeat the treatment.
5, Patients with trigeminal neuralgia who are too old to tolerate or unwilling to receive open surgery treatment.
Contraindications to radiofrequency treatment of trigeminal neuralgia.
1, uncooperative people, including those with mental disorders.
2. Those with infected lesions in the skin and deep tissues of the puncture site.
3. Those who are allergic to local anesthetics.
4.Patients with tumor-compressed trigeminal neuralgia.
5.Patients with severe hypertension, coronary artery disease, liver and kidney function impairment.
6.Patients with coagulation mechanism disorder and bleeding tendency.
Advantages of radiofrequency treatment of trigeminal neuralgia.
1.Surgery is less dangerous, and serious complications rarely occur.
2, Most radiofrequency thermocoagulation can be performed under local anesthesia.
3.Older and frail patients can sometimes be treated.
4.Simple operation, reliable efficacy.
5.The pain is eliminated and most of the tactile sensation exists.
6.If the initial operation is not successful, it can be repeated. It is also possible to treat again after recurrence and still be effective.
7.The operation is inexpensive, and drug treatment can be stopped after successful treatment.
Complications of radiofrequency treatment of trigeminal neuralgia.
1, facial numbness.
2.Sluggish corneal reflex or paralytic corneal ulcer.
3.Masticatory motor disorder.
4.Decreased visual acuity and diplopia.
5.Other complications: salivation at the corners of the mouth, postoperative sensation of twitching in the affected area, facial herpes zoster and other complications may occur.
Effect of radiofrequency treatment for trigeminal neuralgia.
It is generally believed that the immediate pain relief rate of radiofrequency treatment of trigeminal neuralgia is 91%~99%. In a group of 428 patients, there were 409 cases of complete disappearance of pain after radiofrequency temperature-controlled thermal coagulation treatment, accounting for 95.56% of the number of patients treated, among which there were 5 cases of increased pain after the operation, and the pain disappeared from 2 days to 2 weeks after the operation, which was caused by the cortical trace reaction. The pain was reduced in 13 cases, accounting for 3.04% of the number of patients treated. Six cases were ineffective, accounting for 1.40% of the number of patients treated (all of them contained Ⅰ-branch pain). The total effective rate was 98.59%. 265 cases were followed up from 3 months to 2 years, among which 32 cases showed recurrence symptoms, and the recurrence rate was 12.07%. The pain was stopped by re-frequency treatment.