Reason for Failure of Percutaneous Trigeminal Neurolysis with Glycerol for Primary Trigeminal Neuralgia and Its Imporvement

Objectives To analyze the reason for the failure of percutaneous trigeminal neurolysis with glycerol for trigeminal neuralgia and to put forward the method to improve it.Methods From January 1997 to December 2002,the percutaneous trigeminal neurolysis with glycerol were done in 516 patients with primary trigemincl neuralgia,among thom,140 did not achieve the complete remission of trigeminal neuralgia.Results The neuralgia was completely remitted by the second percutaneous trigeminal neurolysis with glycerol in 91 cases and by the third neurolysis in 39.The neuralgia was uncharged in 10 cases.The major failure causes included technical difficulties,vasovagal reactions,the absence of a distinct trigger zone,and no analgesia induced by procaine test.Conclusion The skillful technique and proper indication of the trigeminal neurolysis should be grasped.The painlessness induced by procaine test is essential to complete analgesia. The percutaneous trigeminal neurolysis with glycerol is a minimally invasive, safe,and effective method to treat trigeminal neuralgia.