gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Trigeminal neuralgia: Clinical results and quality of life in the elderly

Meeting Abstract

  • Raphaela Borowka - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany
  • Nils-Ole Schmidt - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany
  • Heidi Kränzlein - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany
  • Marvin Henze - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany
  • Manfred Westphal - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany
  • Jan Regesberger - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1667

DOI: 10.3205/10dgnc140, URN: urn:nbn:de:0183-10dgnc1408

Published: September 16, 2010

© 2010 Borowka et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: This study evaluates the clinical results and quality of life (QoL) after surgical treatment for trigeminal neuralgia (TN) in patients over 70 years.

Methods: A total of 96 TN-patients were treated between 1998–2009 in which microvascular decompression (MVD) or percutaneous electrocoagulation (PE) of the gasserian nerve portion were the choice of treatment. Patients were evaluated for their clinical outcome and their QoL according to the SF-36 survey. Patients were divided into two groups: A) younger than 70 years and B) older than 70 years to scrutinize our decision making treating TN-patients.

Results: Mean follow-up was 4,9±5,4 years (mean±SD). Complete pain relief was seen after MVD in 84% in group A and in 92% in group B. Clinical outcome was favorable (pain free) in 17% of patients in group A and in 23% of patients in group B treated by peripheral electrocoagulation. Recurrence rate in group A was 6% following MVD, in group B no recurrence was seen. In the PE-group recurrence rate was 66%, not differing in the groups A and B. QoL in MVD-patients showed a significant improvement concerning physical and mental items. PE did not improve patients QoL, independent to their age.

Conclusions: Clinical outcome in TN-patients older than 70 years and treated by MVD do not give evidence for increased morbidity and lower success rates. QoL improves remarkable, especially in the older age. Therefore MVD should be the choice of treatment and PE reserved for those few patients only in which radiological signs of demyelination at the trigeminal nerve root (e.g. in multiple sclerosis) may expect failure of MVD.