Treatment of neuralgia of the trigeminal nerve is manifold. Prescribed anticonvulsant drugs that prevent the development of an attack of pain (carbamazepine, finlepsin, Tegretol), vascular drugs, antispasmodics, sedatives. Acupuncture is widely used in physiotherapy procedures (applications with paraffin, currents of Bernard).
For the treatment of neuralgia, laser radiation is applied along the margins in the region of the exit of the branches of the trigeminal nerve from the skull.
A number of authors recommend carrying out different methods of therapy (plasmapheresis, chemisorption). Despite a variety of conservative methods of treatment, including drug therapy, physiotherapy, traditional medicine, the main method of treatment today is the surgical one. The operation relieves the patient of pain permanently or for a long time. But it is pain that is the main complaint of the patient.
To get rid of the pain or reduce pain, even for a short time, alcohol-Novocain blockades are widely used in the point of exit of the trigeminal branch of the trigeminal nerve. Unfortunately, even with an effective blockade, it lasts for a short time and the pain resumes. The therapeutic effectiveness of repeated blockades decreases with each time, the duration of remission (cessation of pain) also decreases.
The search for the most effective and safe method of surgical treatment of trigeminal neuralgia has been going on for more than a century. The first attempts at surgical treatment were made in the middle of the 18th century and often had a dramatic character, ending in the fatal outcome. Trepanation of the skull was performed to affect the trigeminal nerve, often accompanied by life-threatening bleeding. After the operation, many patients developed complications accompanied by paresis, paralysis, and visual impairment. Even in the 50-60s of the 20th century, after open access operations, a large percentage of serious complications were observed, and postoperative mortality reached 2-3%. The surgical methods of treatment were gradually improved, becoming more and more safer.
Methods of surgical treatment of neuralgia of the trigeminal nerve
Currently, two methods of surgical treatment are widely used in the world.
The first is the microvascular decompression of the spine of the trigeminal nerve. Microvascular decompression consists of the trepanation of the posterior cranial fossa, revision of the relationship of the spine of the trigeminal nerve, upper and lower anterior cerebellar arteries, and the upper stony vein. When the spine is compressed with blood vessels, they are isolated, and a gasket is placed between the vessels and the spine, preventing contact between them and the effect of the vessel on the spine.
However, the neurovascular conflict is not always the cause of the disease. In addition, for patients with severe concomitant somatic pathology, and patients of senile age, carrying out this operation is risky.
Currently, in Russia and abroad, one of the most common methods of treatment of trigeminal neuralgia is percutaneous radiofrequency destruction of the trigeminal nerve roots.
This method is most effective, practically has no serious complications. Radiofrequency destruction is based on the physical principle of thermocoagulation and is based on the effect of the release of thermal energy when passing through the biological tissues of ultrahigh-frequency currents. The electrode connected to the current generator is led to the site of destruction through an isolated cannula. The intensity of tissue heating depends on its resistance. The electric current passes between the active or damaging electrode immersed in the body tissues and an indifferent or scattered electrode. Heat production, and as a result, destruction of tissues, occurs only around the uninsulated tip of the active electrode. The main advantage of the method of radiofrequency thermal destruction is that the size of the damage zone can be adequately controlled, and the electrode with the temperature sensor registers the temperature in the damage zone. It is possible to set the exact time of the damage, and the control of the electrical stimulation and resistance level allows the electrode to be correctly and accurately set. The use of local anesthesia provides a short recovery period, and if necessary, repeated sessions of radiofrequency thermal destruction are possible.
Criteria for selecting patients for the procedure for radiofrequency destruction are the duration of the pain syndrome for more than 4-12 months; unstable effect or its absence after drug therapy; Absence of gross violations of anatomic relationships in the skull.
Neurosurgeons and now continue to improve existing surgical procedures, striving for an ideal surgical operation that would be safe for the patient, permanently relieve pain without causing any complications.
Thus, to date, medicine has a large set of conservative and surgical methods for treating trigeminal neuralgia.
Contact the DMC clinic for the treatment of trigeminal neuralgia +99895 475 03 03
