John G. Golfinos, M.D., A.B.
Departments of Neurosurgery & Otolaryngology
NYU School of Medicine
530 First Avenue, Suite 8R
New York, NY 10016
212-263-2950
http://www.med.nyu.edu/clinicians/golfij01.html
Transcript: MS & trigeminal neuralgia surgical treatments at NYU
Trigeminal neuralgia and multiple sclerosis can often be a very difficult problem to deal with. We find generally that over the long term multiple sclerosis patients will struggle with trigeminal neuralgia and it can be very difficult for us to eradicate their pain completely.
My first choice now for a patient with multiple sclerosis is generally gamma knife radiosurgery. We don’t consider these patients to be candidates for microvascular decompression. If they get good pain relief from the radiosurgery, so much the better.
Our second procedure will generally be a glycerol rhizotomy. Whether it’s a glycerol rhizotomy or thermal rhizotomy I think is up to the surgeon’s preference. It depends on how familiar they are with each technique. I think the published results and certainly our results have been comparable for either technique.
And then if they fail after that procedure which is not uncommon then we’ll consider repeating the gamma knife radiosurgery. Generally, in multiple sclerosis patients, we like to wait at least a year between repeat treatments of gamma knife radiosurgery.