Application of the Barrow pain scale at neurosurgical treatment with Novalis linear accelerator for trigeminal neuralgia, the National Institute of Neurology and Neurosurgery

Abstract

Trigeminal neuralgia (TN) classic, is defined as a disorder characterized brief pain similar to electric shocks, abrupt in onset and termination, limited to the distribution of one or more divisions of the trigeminal nerve. Objective: to present the results of patients undergoing the procedure radiosurgery for trigeminal neuralgia using white as the main entrance area of the root (ZER) of the trigeminal nerve. The pain scale used to display the results is based on the one used at the Barrow Neurological Institute, recorded before the procedure and after radiosurgery. Material and methods: a retrospective study was conducted by reviewing the medical records, obtaining clinical data of 66 patients diagnosed with NT, 18 male and 48 female. Which underwent the procedure neurosurgical, with linear accelerator Novalis, in a period of 2004 to 2013. Tracking was conducted in the outpatient clinic in each patient, the clinical course of pain according to pain scale was registered Barrow Neurological Institute, cited three months.Results: LINAC radiosurgery treatment was applied in 66 patients diagnosed with NT, 18 males (27.3%) and 48 females (72.7%). The age of the patients was 61 to 91 years with a mean of 61.9. The tiempo of disease progression was 1-27 years with a mean of 7.24. The drugs handled after treatment, remained unchanged in 23 patients (34.8%), more drugs were added in 6 patients (9.1%) and there was a decrease in 37 patients (56.1%) The BNI end after treatment was BNI Off 23 patients (34.8%), BNI two 7 patients (10.6%) and five BNI 3 patients (4.5%). The observed complications in 31 patients as facial dysesthesias the treated side (47%). Conclusions: neurosurgical Novalis LINAC in NT with a dose of 85-90 Gy to REZ targeted at the National Institute of Neurology and Neurosurgery according to pain scale Barrow Neurological Institute in 66 cases treated, reported retrospectively, show a improvement of a BNI I-III, is safe with a low complication rate. Another treatment option for refractory NT should be considered a minimally invasive drug.