CLAN 2022 Microvascular decompression for glossopharyngeal neuralgia. A personal serie of 118 cases (A2022 1123).pptx
Microvascular decompression for glossopharyngeal neuralgia. A personal 118 cases serie from Latin America. Glossopharyngeal neuralgia (GPN) is a craniofacial pain syndrome described as electrical discharges in the territory of the IX cranial nerve. A very rare neurovascular compression syndrome/cranial nerve HDS. Incidence 0.2–0.7/100,000 h/year. Misdiagnosis TN (V3). The MVD/MSD is a non-destructive technique focused on nerve isolation. Information about short and long-term efficacy of MVD for GPN is scarce. In our database, from 6 years 10 months we attended 2.248 diagnosis cases of HDS, 118 cases with some type of GPN, 40 simple and 78 combined type, and 34 underwent to MVD in our clinic. Results, we reach pain relief (88%), and poor result due to residual pain, not controlled with medication (5,9%); mortality rate cero. As an effective and safe procedure, minimally invasive MSD should be the first choice as a treatment for GPN, allowing good and excellent relief of glossopharyngeal neuropathic pain in most cases. Neurologia Segura Medical Center
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CLAN 2022 Microvascular decompression for glossopharyngeal neuralgia. A personal serie of 118 cases (A2022 1123).pptx
- 1. Mauro Segura, MD, PhD. Adriana Fernanda Segura Zenón, María Nayeli Rojas Pedroza,Yael Rodrigo Torres Torres, Alejandro GonzálezSilva, Aarón GiovanniMunguía Rodríguez. Neurología SeguraMedicalCenter,Morelia,Michoacán,México. Investigación Segura Microvascular decompression for glossopharyngeal neuralgia. A personal 118 cases serie Miami, Florida, November 22th, 2022
- 2. • Glossopharyngeal neuralgia (GPN) is a craniofacial pain syndrome described as electrical discharges in the territory of the IX cranial nerve. • A very rare neurovascular compression syndrome/cranial nerve HDS. • Incidence 0.2–0.7/100,000 h/year. • Misdiagnosis TN (V3). • The MVD/MSD is a non-destructive technique focused on nerve isolation. Information about short and long-term efficacy of MVD for GPN is scarce. Introduction info@neurologiasegura.net
- 3. January 2016 October 2022 2248 Cases of HDS 118 Cases of GPN 40 Simple 78 Combined 34 MVD Method info@neurologiasegura.net
- 5. Age at MVD x̄ = 55.5 y Evolution of symptoms x̄ = 7.9 y Results info@neurologiasegura.net
- 6. 19 cases (56%) 15 cases (44%) BMI 26.1 BMI 24.2 Results Male Female info@neurologiasegura.net
- 7. 19 cases (56%) 15 cases (44%) Right side Left side Results info@neurologiasegura.net
- 8. Results Triggers Comorbidities info@neurologiasegura.net Tongue base movement 100% Pressure 42% Cold 38% 12.5% 12.5% DM2 71% SAH 58% Negated 41% Others 33% DM2=Diabetes Mellitus SAH = Systemic Arterial Hypertension DLP= Dyslipidemia HT = Hypothyroidism DLP 8% HT 8%
- 9. Vascular and histopatological findings Culprit vessel Arachnoiditis Viscous Fibrosis Calcification PICA AICA VA info@neurologiasegura.net
- 10. Immediate transient complications Headache Dizziness Nausea Mild postoperative complications 1 CSF leak (4%) 5 Transient facial palsy (20.8%) Cough (4%) Dysphonia (4%) Complications info@neurologiasegura.net Mortality rate 0%
- 11. Complementary radiofrecuency Lost follow-up 2 cases (5.9%) Outcome No pain No medication Mild pain No medication Moderate pain Controlled with medication Residual pain Not controlled with medication 22 (64.7%) 4 (11.7%) 2 (5.9%) 4 (11.7%) Outcome info@neurologiasegura.net Pain relief (88%)
- 12. As an effective and safe procedure, minimally invasive MSD should be the first choice as a treatment for GPN, allowing good and excellent relief of glossopharyngeal neuropathic pain in most cases. Conclusion info@neurologiasegura.net
Editor's Notes
- The purpose of this study is to demonstrate the safety and efficacy of MVD to treat GPN in our medical center, as well as to inform the microsurgical findings during this surgery.