Balloon compression for treatment of Trigeminal Neuralgia: as the name implies, in this procedure a balloon is used to compress the Trigeminal ganglion.
How is Balloon compression for treatment of TN performed?
Just like for RFLG or Glycerol injection, a needle is passed (albeit bigger) carrying the balloon. This is done under general anesthesia or deep sedation, because it is more painful than RFLG or Glycerol injection.
How does Balloon compression for trigeminal neuralgia work?
The squeeze-compression induced by the balloon damages the myelin of the larger nerve fibres. These are the fibres that trigger the TN attacks.
How is balloon compression different from RFLG for treatment of trigeminal neuralgia?
In RFLG, the needle size is small, and the lesioning is made with heat. This damages the pain fibres which don’t actually trigger the pain attacks in Trigeminal neuralgia. This is why corneal numbness and anaesthesia dolorosa are less common with balloon compression.
In what type of TN is balloon compression effective?
Like most interventions to control pain, this is also most effective in Type 1 TN, and in TN caused by Multiple sclerosis.
What are the success rates of Balloon compression for treatment of pain due to TN?
This depends on who does it, and rates vary from centre to centre. It could be anywhere from 50-80%.
What are the main drawbacks of Balloon compression?
- limited success rates
- failures highest in first year or two
- Recurrence, especially in the first year or two
- Repeat procedures likely
- repeat procedures likely to be less successful
- mild facial numbness
- jaw-muscle weakness leading to difficulty in chewing
Is it useful for multiple sclerosis patients?
It is of limited use in trigeminal neuralgia caused by multiple sclerosis.
How does Balloon compression favour against Microvascular decompression?
It is a relatively new procedure, has less success rates, more recurrences etc. Repeat procedures need to be done more frequently.
Microvascular decompression for Trigeminal neuralgia is a surgery that treats the problem that caused the pain in the first place. It separates the trigeminal nerve from the vessel compressing it, by using a teflon sponge. Dr Jaydev Panchwagh’s team has a success rate of nearly 97-98% at their MVD centre in Pune, India. He has many national and international patients coming to him to undergo this surgery.