Correlation of clinical findings and results of percutaneous balloon compression for patients with trigeminal neuralgia

Objective: To investigate pain relief and recurrence after percutaneous balloon compression (PBC) and its association with type of pain, prior surgery, or other clinical factors. Methods: Fifty-nine patients with medically refractory trigeminal pain were enrolled into this study. Patients were divided into those with typical trigeminal neuralgia (TN), and those with other types of trigeminal pain or "atypical pain." The post-surgical rate of recurrence was estimated by the Kaplan-Meier method. Cox-proportional hazards models were used to investigate associations between patient characteristics and recurrence of pain. Results: Forty-two patients had TN, 17 patients had atypical pain. At last follow-up, 40 patients had excellent, 9 good, 7 fair and 3 poor pain relief. Recurrence was observed in 35 patients, and was associated with pain type (relative risk (RR) = 2.38, 95% confidence interval (CI): 1.22-4.63, P = 0.011) and pain duration before PBC (RR = 1.33, 95% CI: 1.02-1.72, P = 0.033). Other clinical factors were not significant. Two patients had transient paresis of the sixth cranial nerve, however, there were no permanent post-surgical complications. Conclusions: Our study demonstrates the safety and efficacy of PBC with 83% of patients being pain free at last follow-up. Patients with atypical pain and longer pre-surgical symptom duration appear to have a higher risk of recurrence. Repeat surgery is just as effective as initial surgery, justification for being conservative in parameter selection at the initial procedure to minimize complications.