The drug therapywhich is the first choice for treating the trigeminal neuralgia in people with multiple sclerosis, it can however cause some important side effects, which are felt more in people with motor and walking difficulties and with some cognitive disorders such as memory.
In these people, percutaneous surgical techniques, and in particular the thermorizotomy can represent a valid solution.
What is it
The thermorizotomy it is a technique that allows selectively performing a lesion in the affected trigeminal branches and therefore modulating the nerve lesion. It can be done with a hospital stay of a few hours. It is less invasive than other techniques and more precise, since it is based on neurological and radiological monitoring during execution.
To obtain adequate relief from the pain of trigeminal neuralgia and a complete suspension of drug therapy it is sufficient to obtain only facial hypoalgesia, i.e. a reduction in sensitivity to pain, leaving skin sensitivity intact. This is a fundamental aspect of the procedure which avoids the risk of “painful” anesthesia and possible motor disorders.
After the procedure, the person is awakened for the stimulation phase and verification of the correct positioning of the electrode, followed by the neurolesion and verification of the level of hypoalgesia obtained.
Subsequently it is possible to suspend the pharmacological therapy for the control of trigeminal pain progressively within 15-30 days, the duration of the treatment is 2-5 years and can be repeated several times when the pain returns.
Bibliography
- Kyung Won Chang et al. – J Korean Neurosurg Soc. 2022 Sep.- Percutaneous Procedures for Trigeminal Neuralgia
- André Marques Mansano et al. – Pain Med. 2023 – Percutaneous Radiofrequency Ablation for Trigeminal Neuralgia Management: A Randomized, Double-Blinded, Sham-Controlled Clinical Trial
- Giulia Di Stefano et al. – Pain 2019 – Trigeminal neuralgia secondary to multiple sclerosis: from the clinical picture to the treatment options
- Pavlos Texakalidis et al. – World Neurosurg. 2021 Feb – Percutaneous Surgical Approaches in Multiple Sclerosis-Related Trigeminal Neuralgia: A Systematic Review and Meta-analysis
- Nicola Montano et al. – Clin Neurol Neurosurg. 2013 May – What is the best treatment of drug-resistant trigeminal neuralgia in patients affected by multiple sclerosis? A literature analysis of surgical procedures
- Diana Ferraro et al. – Mult Scler Relat Disord. 2020 Jan. – Characteristics and treatment of Multiple Sclerosis-related trigeminal neuralgia: An Italian multi-centre study
- Seyed H Mousavi et al. – Neurosurgery. 2022 – The Long-Term Outcome of Radiofrequency Ablation in Multiple Sclerosis-Related Symptomatic Trigeminal Neuralgia.
What are the Long-term effects of drug therapy for trigeminal neuralgia in patients with multiple sclerosis?
Guest 1: Dr. X, a neurologist specializing in the treatment of trigeminal neuralgia in multiple sclerosis patients, please share your insights on the importance of drug therapy for this condition.
Dr. X: Drug therapy is the first line of treatment for trigeminal neuralgia in people with multiple sclerosis. It can effectively manage pain and other symptoms associated with the condition. However, it can cause side effects, including motor and walking difficulties and cognitive disorders like memory loss.
Guest 2: Ms. Y, a patient living with multiple sclerosis and experiencing trigeminal neuralgia, can you tell us about your experience with drug therapy?
Ms. Y: I took medication for my trigeminal neuralgia for three years but experienced severe side effects, including dizziness, fatigue, and blurred vision. It affected my quality of life significantly. I was hesitant to try another treatment option but my doctor suggested thermorizotomy.
Guest 1: Dr. X, can you explain thermorizotomy and its benefits over other treatments for trigeminal neuralgia in people with multiple sclerosis?
Dr. X: Thermorizotomy is a percutaneous surgical technique that targets the affected trigeminal branches and modulates the nerve lesion. It is less invasive and more precise than other techniques, as it is based on neurological and radiological monitoring during execution. This means there is a lower risk of complications like motor disorders and cognitive impairment.
Guest 2: Ms. Y, what was your experience with thermorizotomy?
Ms. Y: The procedure took a few hours, and I experienced minimal discomfort. To my surprise, I regained some sensitivity in my face but not enough to negatively impact my daily life. My pain levels decreased significantly, and I was eventually able to discontinue my medication completely.
Guest 1: Dr. X, what is the importance of achieving facial hypoalgesia, or a reduction in sensitivity to pain, during thermorizotomy?
Dr. X: Facial hypoalgesia is crucial in obtaining adequate relief from trigem
