Cryotherapy for trigeminal neuralgia: a 10 year audit

Abstract

The outcome of treatment for trigeminal neuralgia was evaluated in 145 patients treated with cryotherapy, 265 patients treated with radiofrequency thermocoagulation and 65 patients treated with microvascular decompression. Median duration of pain relief was 6 months after cryotherapy and 24 months after thermocoagulation. Sixty-two per cent of patients were pain-free 5 years after decompression. When pain recurred after cryotherapy it affected the same sites as previously in 80% of patients. Repeated cryotherapy of mental and long buccal nerves, but not of infra-orbital nerves, gave more prolonged pain relief than initial cryotherapy. One third of cryotherapy and thermocoagulation patients had atypical facial pain after treatment. Psychometric testing suggested that levels of anxiety and depression were similarly reduced after the three treatment methods. Outcome data should be used to help new patients make informed choices about their treatment.