Evaluation of patients with atypical trigeminal neuralgia for permanent electrode implant by test stimulation of the ganglion gasseri.

The treatment of so-called atypical trigeminal neuralgia, characterized by long-lasting burning pain sensations without any pain attacks was for a long time an unsolved problem in contrast to the so-called 'tic douloreux'. Following the experience with our own patients and other groups, destructive procedures in atypical trigeminal neuralgia frequently result in worsening of the clinical conditions. We have therefore transferred the well-established method in the periphery of therapeutic electrostimulation to the trigeminal region. The evaluation of the patients with atypical trigeminal neuralgia is the key for good therapeutic results. Therefore percutaneous test stimulation of the ganglion gasseri has to be performed during a hospital stay. 54% of 149 patients experienced pain relief during test stimulation. Therefore in 81 patients with positive test results, electrodes were implanted together with a neurological pulse generator (Itrel Medtronic).