Theodosopoulos et al identified risk factors associated with recurrent pain in patients who have had surgery in the posterior fossa for relief of trigeminal neuralgia. This can be useful in counseling patients prior to the original surgery and for monitoring afterwards. The authors are from the University of California at San Francisco.
Major risk factors for pain recurrence:
(1) female gender
(2) males with left-sided pain distribution
Minor risk factors:
(1) age of the patient < 53 years at the time of surgery
(2) duration of symptoms > 11.5 years
Risk Factor |
Hazard Ratio |
female |
3.9 (right-sided pain); 4.7 (left-sided pain) |
male with left sided pain distribution |
5.6 |
age < 53 years |
2.8 |
duration of symptoms > 11.5 years |
2.0 |
from Table 4, page 1300
Risk Group |
Risk Factors |
low |
1 minor |
moderate |
1 major |
high |
2 or more in any combination |
Patients with Immediate Pain Relief by Risk Group |
Pain Free at 4 Years |
Pain Free at 10 Years |
low |
89 +/- 4% |
89 +/- 4% |
moderate |
80 +/- 4% |
71 +/- 5% |
high |
58 +/- 6% |
47 +/- 7% |
All Patients by Risk Group |
Pain Free at 4 Years |
Pain Free at 10 Years |
low |
87 +/- 4% |
87 +/- 4% |
moderate |
77 +/- 4% |
68 +/- 5% |
high |
56 +/- 5% |
47 +/- 6% |
Purpose: To determine the risk of pain recurrence in a patient with trigeminal neuralgia undergoing posterior fossa surgery for relief.
Specialty: Neurology
Objective: risk factors, complications, surgery
ICD-10: G50.0,