Skip to main content
SpringerLink
Log in

Glycerol Rhizolysis for Trigeminal Neuralgia

  • Chapter
  • First Online:
Handbook of Trigeminal Neuralgia

  • 1163 Accesses

Abstract

A plethora of percutaneous procedures are available for the management of trigeminal neuralgia (TGN). Percutaneous procedures are useful in patients with drug-refractory TGN, who either refuse surgery, or in those with significant medical risks to undergo invasive surgical procedures. Percutaneous retrogasserian glycerol rhizolysis (PRGR) is one of the most popular methods of treatment for TGN. PRGR is carried out by injecting glycerol into the Meckel’s cave and its safety has been established by several studies [1–4]. The major advantages of PRGR are: (1) long-term pain relief following single injection, (2) significant reduction in postoperative facial deafferentation compared to thermal rhizotomy, and (3) simple to perform with an image intensifier. Precise anatomic placement of anhydrous glycerol is achieved with the help of intraoperative trigeminal water-soluble contrast cisternography prior to drug injection [5–8].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hakanson S. Trigeminal neuralgia treated by the injection of glycerol in trigeminal cistern. Neurosurgery. 1981;9:38–46.

    Article  Google Scholar 

  2. Saini SS. Injection treatment of trigeminal neuralgia with special reference to the use of anhydrous glycerol. Neurol India. 1981;29:31–4.

    Google Scholar 

  3. Lunsford LD. Treatment of tic douloureux by percutaneous retrogasserian glycerol injection. JAMA. 1982;248:449–53.

    Article  CAS  Google Scholar 

  4. Arias MJ. Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia. J Neurosurg. 1986;65:32–6.

    Article  CAS  Google Scholar 

  5. Saini SS. Reterogasserian anhydrous glycerol injection therapy in trigeminal neuralgia: observations in 552 patients. J Neurol Neurosurg Psychiatry. 1987;50:1536–8.

    Article  CAS  Google Scholar 

  6. Burchiel KJ. Percutaneous retrogasserian glycerol rhizolysis in the management of trigeminal neuralgia. J Neurosurg. 1988;69:361–366.8.

    Article  CAS  Google Scholar 

  7. Kondziolka D, Lunsford LD. Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia: technique and expectations. Neurosurg Focus. 2005;18:E7.

    Article  Google Scholar 

  8. Dash HH. Management of patients with Trigeminal neuralgia. J Anaesth Clin Pharmacol. 1999;15:541–3.

    Google Scholar 

  9. Rath GP, Dash HH, Prabhakar H, Pandia MP. Cardiorespiratory arrest during anhydrous glycerol injection for trigeminal rhizolysis. Anaesthesia. 2007;62:971–2.

    Article  CAS  Google Scholar 

  10. Arishima H, Kawajir S, Arai H, Higashino Y, Kodera T, Kikuta K. Percutaneous glycerol rhizotomy for trigeminal neuralgia using a single plane, flat panel detector angiography system: technical note. Neurol Med Chir (Tokyo). 2016;65:257–63.

    Article  Google Scholar 

  11. Pandia MP, Dash HH, et al. Does egress of cerebro-spinal fluid during percutaneous retrogasserian glycerol rhizotomy influence by long term pain relief? Reg Anesth Pain Med. 2008;33:222–6.

    Article  Google Scholar 

  12. Lunsford LD. Identification of Meckel cave during percutaneous glycerol rhizotomy for Tic Douloureux. AJNR. 1982;3:680–2.

    CAS  PubMed  Google Scholar 

  13. Pal HK, Dinda AK, Roy S, Banerji AK. Acute effect of glycerol on peripheral nerve: An experimental study. Br J Neurosurg. 1989;3:463–9.

    Article  CAS  Google Scholar 

  14. Normikko TJ, Eldridge PR. Trigeminal neuralgia - pathophysiology, diagnosis and current treatment. Br J Anaesth. 2001;87:117–32.

    Article  Google Scholar 

  15. Calvin WH, Loeser JD, Howe JF. A neurophysiological theory for the pain mechanism of tic douloureux. Pain. 1977;3:147–54.

    Article  CAS  Google Scholar 

  16. Udupi BP, Chouhan RS, Dash HH, Bithal PK, Prabhakar H. Comparative evaluation of percutaneous retrogasserian glycerol rhizolysis and radiofrequency thermocoagulation techniques in the management of trigeminal neuralgia. Neurosurgery. 2012;70:407–12.

    Article  Google Scholar 

  17. Noorani I, Lodge A, Vajramani G, Sparrow O. Comparing percutaneous treatments of trigeminal neuralgia: 19 years’ experience in single centre. Stereotact Funct Neurosurg. 2016;94:75–85.

    Article  Google Scholar 

  18. Kumar R, Mahapatra AK, Dash HH. Blink reflex before and after percutaneous glycerol rhizolysis in patients with trigeminal neuralgia: a prospective study of 28 patients. Acta Neurochir. 1995;137:80–5.

    Article  Google Scholar 

  19. Asplund P, Blomstedt P, Bergenheim AT. Percutaneous balloon compression vs percutaneous retrogasserian glycerol rhizotomy for the primary treatment of trigeminal neuralgia. Neurosurgery. 2016;78:421–8.

    Article  Google Scholar 

  20. Kouzounias K, Lind G, Schechtmann G, Winter J, Linderoth B. Comparison of percutaneous balloon compression and glycerol rhizotomy for the treatment of trigeminal neuralgia. J Neurosurg. 2010;113:486–92.

    Article  Google Scholar 

  21. Kodeeswaran M, Ramesh VG, Saravanan N, Udesh R. Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia: a simple, safe, cost-effective procedure. Neurol India. 2015;63:889–94.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Anesthesiology and Pain Management, Fortis Memorial Research Institute (FMRI), Gurugram, Haryana, India

    Hari Hara Dash

Authors
  1. Hari Hara Dash
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India

    Girija Prasad Rath

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dash, H.H. (2019). Glycerol Rhizolysis for Trigeminal Neuralgia. In: Rath, G. (eds) Handbook of Trigeminal Neuralgia. Springer, Singapore. https://doi.org/10.1007/978-981-13-2333-1_18

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-2333-1_18

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-2332-4

  • Online ISBN: 978-981-13-2333-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation