Double-guided Method Adriamycin Therapy For Primary Trigeminal Neuralgia

Objective:To evaluate the effective and safety of double-guided method adriamycin therapy for primary trigeminal neuralgia.Methods:161 patients with trigeminal neuralgia were treated with intervention techniques during April 2005 and August 2007.Take 34 patients(group A1)randomly were treated with double-guided method adriamycin.Therapeutic outcome(VAS score, sleep time,frequency of breakthrough pain,efficiency and adverse reactions)of 34 patients(group A1)were assessed one week,one month,two months after treatment. The other 127 patients were divided into two groups randomly.63 patients(group A2) were treated with double-guided method adriamycin,64 patients(group B)were treated with radiofrequency thermocoagulation of the Gasserian ganglion. Therapeutic outcome(VAS score,efficiency and adverse reactions)of group A2 and group B were assessed one day,one week,three months,six months after treatment. To observe the therapeutic effects and adverse effects of radiofrequency thermocoagulation of the Gasserian ganglion and double-guided method adriamycin in the treatment of trigeminal neuralgia.Results:Group A1,the difference in VAS score,sleep time,frequency of breakthrough pain after the treatment was statistically significant compared with before the treatment,the difference in VAS score,sleep time,frequency of breakthrough pain one month,two month after the treatment was statistically significant compared with one week after the treatment,the difference in VAS score three month after the treatment was statistically significant compared with one month after the treatment.The difference in sleep time,frequency of breakthrough pain was statistically significant compared with one month after the treatment.Two months after the treatment the efficiency was 100%.One week after the treatment in the 97 patients with double-guided method adriamycin treatment 15 patients had a mild decline of felling,the ratio was 15.46%.Three months after the treatment 9 patients had a mild decline of felling,the ratio was 11.34%.None of the patients had visual disturbance,difficulty of opening the mouth.One week after the treatment in the 64 patients with radiofrequency thermocoagulation of the Gasserian ganglion,64 patients had a mild decline of felling,the ratio was 100.00%.Three months after the treatment 62 patients had a mild decline of felling,the ratio was 96.88%.The difference in VAS score one day,one week,three months after the treatment was statistically significant compared with group A2 and group B.The difference in efficiency one day,one week,three months after the treatment was statistically significant compared with group A2 and group B.The difference in VAS score and efficiency one day,one week,three months after the treatment was not statistically significant compared with group A2 and group B.The difference in the occurrence rate of facial numbness and masticatory weakness one week,three months after the treatment was statistically significant compared with two methods.Conclusion:Double-guided method adriamycin therapy for primary trigeminal neuralgia has the characteristics of accuracy of operation,high cure rate,stability in the short-term follow-up.The supreme characteristic of this method is maintenance of the feeling function of trigeminal nerve,so it's worthy to generalize in clinic.