RESEARCH – June 2017

Evaluation of postoperative change in the quality of life of patients with trigeminal neuralgia

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Background and aims. Trigeminal neuralgia is a disorder that can cause excruciating pain and diminish the quality of life. We examined and compared the effectiveness and observed influence of microvascular decompression (MVD) and percutaneous retrogasserian glycerol rhizotomy (PRGR), both used in the treatment of trigeminal neuralgia, on the quality of life.

Methods. We asked all reachable patients, treated with MVD or PRGR in Estonia between 2002 and 2013, to fill in three questionnaires in order to provide us with information about their emotional state and influence of the disease on life before and after receiving treatment.

Results and conclusions. We received feedback from 79 out of 127 patients (62.2%). Pain intensity ranged from 9.1 points to an average of 1.7 points after MVD and from 8.3 to 3.2 after PRGR. At the time of the interview, pain intensity was 1.5 points for the patients treated with MVD and 3.5 for those treated with PRGR. Also, the number of completely pain-free patients increased over time after MVD, while no such change was seen in the patients after PRGR. Eating and/or speaking disturbance disappeared in 66.7% of the patients after MVD and in 26.3% of the patients after PRGR. Anticonvulsant use dropped from 94.7% to 35.9% in the MVD group and from 93.8% to 67.6% in the PRGR group. Patients assessed more invasive MVD as causing significantly more visual, auditory and/or balance and sensory disturbances. The results of the Emotional State Questionnaire 2 (ESQ-2) and the Headache Impact Test 6 (HIT-6) were not significantly different between the patient groups. Both methods are effective in the treatment of trigeminal neuralgia. The MVD is the preferred method in providing relief from complaints caused by the disorder. However, in certain cases PRGR should be considered the first line treatment.