gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Percutaneous treatment for trigeminal neuralgia: experience with 609 procedures

Perkutane Behandlungsverfahren bei Trigeminusneuralgie: eigene Erfahrungen über 609 Eingriffe

Meeting Abstract

  • corresponding author U. M. Bäzner - Neurosurgical Department of the University of Ulm, Günzburg
  • V. Braun - Neurosurgical Department of the University of Ulm, Günzburg
  • H.-P. Richter - Neurosurgical Department of the University of Ulm, Günzburg
  • G. Antoniadis - Neurosurgical Department of the University of Ulm, Günzburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP035

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Bäzner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




After failure of medical therapy, trigeminal neuralgia can be treated by several neurosurgical interventions: microvascular decompression, percutaneous rhizolysis by intragasserian thermocoagulation, microcompression with balloon or retrogasserian glycerol injection. The aim of this study is to analyse the long-term outcome of the common percutaneous techniques.


In a retrospective study, 383 patients with trigeminal neuralgia or atypical facial pain were treated between August 1979 and January 2004 in our department. Altogether a total of 609 percutaneous interventions were performed. 287 patients suffered from trigeminal neuralgia, 67 from multiple sclerosis associated with trigeminal neuralgia and 50 from atypical facial pain.

278 thermo-controlled rhizotomies, 214 glycerol injections and 17 microcompressions of the ganglion gasseri were performed. The average follow-up period was 40 months. The women to men ratio was 1.4: 1.0 (associated with multiple sclerosis: 1.1: 1.0). The average age is 74 years (MS: 52ys, atypical pain: 57ys).


The results were presented separately for the different kinds of facial pain, especially regarding the patients with multiple sclerosis associated trigeminus neuralgia. A persistent effect (more than 1 year) was found after glycerol injections in 77% (MS: 72%), after thermocoagulation in 71% (MS: 83%) and after microcompression in 78% (MS: 75%).

In our series of 609 percutaneous procedures, we found one patient with acute subdural hemorrhage and 7 patients with aseptic meningitis after glycerol injection, indicating a morbidity risk of 1.3%.

We found persistent sensory deficits - which did not trouble the patients - in 24% of the glycerol injections; in 52% of the thermo-controlled rhizotomies and in 78% of the microcompressions.


After failure of conservative treatment or because of the untoward side effects, neurosurgical intervention should be considered for trigeminal neuralgia. None of the above mentioned surgical procedures offers a causal therapy. The individual situation and a careful preoperative evaluation are necessary and essential to select one of these procedures.