Radiofrequencia-termocoagulacao no tratamento da neuralgia do trigemio: analise de 100 casos

Motta, Pedro; Souza, Mario Tadeu Kroeff de; Sengupta, R. P.

doi:10.1590/S0004-282X1980000100005

Resumos

É relatada uma série de 100 pacientes com neuralgia do trigêmio tratados mediante termocoagulação percutânea com radiofrequência do gânglio de Gasser. Os autores descrevem os princípios básicos da termocoagulação e comentam alguns métodos terapêuticos empregados no combate da dôr antes do desenvolvimento dessa nova técnica. São relatadas as diferentes fases do procedimento cirúrgico, sendo os resultados analizados. Os autores concluem que a termocoagulação percutanea com radiofrequência tem se tornado o tratamento de escolha para a neuralgia do trigêmio nos pacientes em que o tratamento clínico não mais controla a dôr ou seus efeitos colaterais contraindicam o seu uso.

A series of 100 patients suffering from trigeminal neuralgia treated by percutaneous radiofrequency thermocoagulation of the trigeminal ganglion is reported. The authors make some considerations about the basic principles of the thermocoagulation and comment a few important methods of treatment used prior to this new technique. The whole sequency of the surgical procedure is described and its results analysed. The final conclusion is that percutaneous radiofrequency thermocoagulation has become the treatment of choice for trigeminal neuralgia when the clinical treatment is not anymore effective or the side-effects of the drugs contraindicate its use.

Radiofrequencia-termocoagulacao no tratamento da neuralgia do trigemio: analise de 100 casos

Treatment of trigeminal neuralgia by percutaneous radiofrequency thermo-coagulation: analysis of 100 cases

Pedro Motta^I; Mario Tadeu Kroeff de Souza^II; R. P. Sengupta, M.S.c., F.R.C.S

^IResearch fellow, University of Newcastle upon Tyne

^IIResidente de Neurocirurgia no Regional Neurological Centre, Newcastle General Hospital

RESUMO

É relatada uma série de 100 pacientes com neuralgia do trigêmio tratados mediante termocoagulação percutânea com radiofrequência do gânglio de Gasser. Os autores descrevem os princípios básicos da termocoagulação e comentam alguns métodos terapêuticos empregados no combate da dôr antes do desenvolvimento dessa nova técnica. São relatadas as diferentes fases do procedimento cirúrgico, sendo os resultados analizados. Os autores concluem que a termocoagulação percutanea com radiofrequência tem se tornado o tratamento de escolha para a neuralgia do trigêmio nos pacientes em que o tratamento clínico não mais controla a dôr ou seus efeitos colaterais contraindicam o seu uso.

SUMMARY

A series of 100 patients suffering from trigeminal neuralgia treated by percutaneous radiofrequency thermocoagulation of the trigeminal ganglion is reported. The authors make some considerations about the basic principles of the thermocoagulation and comment a few important methods of treatment used prior to this new technique. The whole sequency of the surgical procedure is described and its results analysed. The final conclusion is that percutaneous radiofrequency thermocoagulation has become the treatment of choice for trigeminal neuralgia when the clinical treatment is not anymore effective or the side-effects of the drugs contraindicate its use.

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Trabalho do Regional Neurological Centre, Newcastle General Hospital, Newcastle upon Tyne, England.

Regional Neurological Centre, Ward 31 - Newcastle General Hospital - Westgate Road - Newcastle upon Tyne, NE4 6BE - England.

1. ANDRE, N. - Observation sur les Maladies de l'Urethre et sur Plusieurs Faits Convulsifs. Delaguette, Paris, 1756, p. 323.
2. FRIGYESI, T. L.; SIEGFRIED, J. & BROGGI, G. - The selective vulnerability of evoked potentials in the trigeminal sensory root to graded thermcoagulation. Exp. Neurology 49:11, 1975.
3. HORSLEY, V.; TAYLOR, J. & COLMAN, W. S, - Remarks on the various surgical procedure devised for the relief or cure of trigeminal neuralgia. British Med. J. 1139:1191, 1891.
4. HARTEL, F. - Die Behandlug der Trigeminus Neuralgie mit intrakraniellen Alkoholeinspritzungen. Deutsch. Z. Chir. 126:429, 1914.
5. KIRSCHNER, M. - Zur Elektrochirurgie. Arch. Klin. Chir. 167:761. 1931.
6. LETCHER, F. S. & GOLDRIN, S. - The effect of radiofrequency current and heat on peripheral nerve action potential in the cat. J. Neurosurg 29:42, 1968
7. NUGENT, G. R. & BERRY, B. - Trigeminal neuralgia treated by differential percutaneous radiofrequency coagulation of the Gasserian ganglion. J. Neurosurg. 40:517, 1974.
8. ONOFRIO, B. M. - Radiofrequency percutaneous Gasserian ganglion lesions, results in 140 patients with trigeminal pain. J. Neurosurg. 42:132, 1975.
9. ROTHMAN, K. J. & WEPSIC, J. - Side of facial pain in trigeminal neuralgia J. Neurosurg. 40:514, 1974.
10. SIEGFRIED, J. - 500 percutaneous thermcoagulation of the Gasserian ganglion for trigeminal pain. Surg. Neurol. (Boston) 8:126, 1977.
11. STOOKEY, B. & RANSOHOFF, J. - Trigeminal Neuralgia. Its History and Treatment. Charles C. Thomas, Springfield (Illinois), 1959.
12. STOWSAND, D.; MARKAKIS, E. & LAUBNER, P. - Elektrokoagulation des ganglion Gasgeri bei der idiopathischen Trigeminus Neuralgie. Nervenarzt 44:44, 1973.
13. SCHURMAN, K.; BUTZ, M. & BROCK, M. - Temporal retrogasserian resection of trigeminal root versus controlled elective percutaneous electrocoagulation of the ganglion of Gasser in the treatment of trigeminal neuralgia. Report of a series of 531 cases. Acta Neurochir (Wien) 26:33, 1972.
14. SWEET, W. H. & WEPSIC, J. G. - Controlled thermcoagulation of trigeminal ganglion and rootlets for differential destruction of pain fibers: trigeminal neuralgia. J. Neurosurg. 40:143, 1974.
15. SWEET, W. H. - Treatment of facial pain by percutaneous differential thermal trigeminal rhizotomy. Proc. Neurol. Surg. (Tokyo) 7:153, 1976.
16. TEW, J. M. Jr. & KELLER, J. - The treatment of trigeminal neuralgia by percutaneous radiofrequency technique. Clin. Neurosurg. 24:557, 1977.
17. TURNBULL, I. M. - Percutaneous rhizotomy for trigeminal neuralgia. Surg. Neurol. (Boston) 2:385, 1974.
18. THIRY, M. S. - Experience personelle basee sur 225 cas de nevralgia essentielle du trijumeau traités par eletrocoagulation stereotaxique du ganglion de Gasser entre 1950 et 1960. Neurochirurgie (Paris) 8:86, 1962.
19. WHITE, J. C. & SWEET, W. H. - Pain and the Neurosurgeon: a Forty Years Experience. Charles C. Thomas, Springfield (Illinois), 1969.
20. ZOTTERMAN, Y. - Touch, pain and tickling: an electrophysiological investigation on cutaneos sensory nerves. J. Physiol. 95:1, 1939.

Datas de Publicação

Publicação nesta coleção
22 Ago 2012
Data do Fascículo
Mar 1980

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ANDRE, N. - Observation sur les Maladies de l'Urethre et sur Plusieurs Faits Convulsifs. Delaguette, Paris, 1756, p. 323.

[2] 2. FRIGYESI, T. L.; SIEGFRIED, J. & BROGGI, G. - The selective vulnerability of evoked potentials in the trigeminal sensory root to graded thermcoagulation. Exp. Neurology 49:11, 1975.

[3] 3. HORSLEY, V.; TAYLOR, J. & COLMAN, W. S, - Remarks on the various surgical procedure devised for the relief or cure of trigeminal neuralgia. British Med. J. 1139:1191, 1891.

[4] 4. HARTEL, F. - Die Behandlug der Trigeminus Neuralgie mit intrakraniellen Alkoholeinspritzungen. Deutsch. Z. Chir. 126:429, 1914.

[5] 5. KIRSCHNER, M. - Zur Elektrochirurgie. Arch. Klin. Chir. 167:761. 1931.

[6] 6. LETCHER, F. S. & GOLDRIN, S. - The effect of radiofrequency current and heat on peripheral nerve action potential in the cat. J. Neurosurg 29:42, 1968

[7] 7. NUGENT, G. R. & BERRY, B. - Trigeminal neuralgia treated by differential percutaneous radiofrequency coagulation of the Gasserian ganglion. J. Neurosurg. 40:517, 1974.

[8] 8. ONOFRIO, B. M. - Radiofrequency percutaneous Gasserian ganglion lesions, results in 140 patients with trigeminal pain. J. Neurosurg. 42:132, 1975.

[9] 9. ROTHMAN, K. J. & WEPSIC, J. - Side of facial pain in trigeminal neuralgia J. Neurosurg. 40:514, 1974.

[10] 10. SIEGFRIED, J. - 500 percutaneous thermcoagulation of the Gasserian ganglion for trigeminal pain. Surg. Neurol. (Boston) 8:126, 1977.

[11] 11. STOOKEY, B. & RANSOHOFF, J. - Trigeminal Neuralgia. Its History and Treatment. Charles C. Thomas, Springfield (Illinois), 1959.

[12] 12. STOWSAND, D.; MARKAKIS, E. & LAUBNER, P. - Elektrokoagulation des ganglion Gasgeri bei der idiopathischen Trigeminus Neuralgie. Nervenarzt 44:44, 1973.

[13] 13. SCHURMAN, K.; BUTZ, M. & BROCK, M. - Temporal retrogasserian resection of trigeminal root versus controlled elective percutaneous electrocoagulation of the ganglion of Gasser in the treatment of trigeminal neuralgia. Report of a series of 531 cases. Acta Neurochir (Wien) 26:33, 1972.

[14] 14. SWEET, W. H. & WEPSIC, J. G. - Controlled thermcoagulation of trigeminal ganglion and rootlets for differential destruction of pain fibers: trigeminal neuralgia. J. Neurosurg. 40:143, 1974.

[15] 15. SWEET, W. H. - Treatment of facial pain by percutaneous differential thermal trigeminal rhizotomy. Proc. Neurol. Surg. (Tokyo) 7:153, 1976.

[16] 16. TEW, J. M. Jr. & KELLER, J. - The treatment of trigeminal neuralgia by percutaneous radiofrequency technique. Clin. Neurosurg. 24:557, 1977.

[17] 17. TURNBULL, I. M. - Percutaneous rhizotomy for trigeminal neuralgia. Surg. Neurol. (Boston) 2:385, 1974.

[18] 18. THIRY, M. S. - Experience personelle basee sur 225 cas de nevralgia essentielle du trijumeau traités par eletrocoagulation stereotaxique du ganglion de Gasser entre 1950 et 1960. Neurochirurgie (Paris) 8:86, 1962.

[19] 19. WHITE, J. C. & SWEET, W. H. - Pain and the Neurosurgeon: a Forty Years Experience. Charles C. Thomas, Springfield (Illinois), 1969.

[20] 20. ZOTTERMAN, Y. - Touch, pain and tickling: an electrophysiological investigation on cutaneos sensory nerves. J. Physiol. 95:1, 1939.

Brasil

Brasil

Radiofrequencia-termocoagulacao no tratamento da neuralgia do trigemio: analise de 100 casos

Treatment of trigeminal neuralgia by percutaneous radiofrequency thermo-coagulation: analysis of 100 cases

Resumos

Datas de Publicação