How is PRGR performed for the treatment of trigeminal neuralgia (TN)?

Updated: Jul 11, 2019
  • Author: Manish K Singh, MD; Chief Editor: Robert A Egan, MD  more...
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Answer

In PRGR, a spinal needle likewise penetrates the face, this time to the trigeminal cistern, at which point a cisternogram is obtained with water-soluble contrast material. After removing this material, the surgeon instills anhydrous glycerol, asking the patient to remain seated for an additional 2 hours to fully ablate the nerve.

PRGR may be the favored procedure, as it has a higher efficacy rate and a lower recurrence rate than the alcohol injection and includes only a minimal risk of disturbed facial sensitivity postoperatively. In addition, it is easy to perform, and anesthesia is not needed. However, Cappiabianca et al and Taha and Tew, who favor the radiofrequency rhizotomy, argue that PRGR has the highest rate of pain recurrence. [59, 60]


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