Objective:

Trigeminal neuralgia (TN) is a common cause of facial pain, with a prevalence of 40 per million. This paper is a retrospective 24-month follow-up study of 20 patients with idiopathic drug-resistant TN who underwent balloon compression (BC) or radiofrequency ablation (RFA).

Methods:

When neuralgia affected more than one divisions or it involved ophthalmic division, BC was performed. RFA was performed in neuralgia involving isolated mandibular or maxillary division.

Results:

At all the time points, numerical rating score (NRS) was lower in the BC group, but the difference was not significant. The proportion of patients developing recurrence of pain was lower in the BC group, but the difference was not significant (p-value 0.63). The proportion of patients requiring a repeat procedure was lower in the BC group, but the difference was not significant. There was no significant correlation among recurrence of pain, age of the patient and number of divisions in which neuralgia was present. In BC, a pear shape of the balloon is desirable, but this shape is not always achievable. Recurrence of pain in the BC group was comparable to that in the available literature, but the recurrence rate in the RFA group was comparatively higher. The complications in BC were higher, but they were transient and improved with time.

Conclusion:

BC and RFA are effective modalities of treatment for idiopathic TN with comparable results. In TN involving multiple divisions, BC may be more convenient.

Keywords: Balloon compression, gasserian ganglion, radiofrequency ablation, trigeminal neuralgia