Multimodal treatment of multiple sclerosis related trigeminal neuralgia: A single centre experience.

INTRODUCTION: Multiple sclerosis-related trigeminal neuralgia (MSrTGN) is a challenging disease, often intractable and associated with frequent relapses. This study aims to investigate different modalities for the neurosurgical management of this condition. METHODS: In a single centre offering three different modalities-radiofrequency ablation (RF), gamma knife radiosurgery (GKRS), and microvascular decompression (MVD)-42 patients treated for MSrTGN were retrospectively analysed. Treatment outcomes, relapse-free survival, and repeat and retreatment procedures were analysed and compared across modalities. RESULTS: RF provided better initial pain control with higher VAS reduction compared to GKRS for MSrTGN patients. Time to second or third procedures and time to relapse did not differ significantly between modalities. CONCLUSION: RF and GKRS are both valid treatment options for MSrTGN, showing similar time-to-relapse and time-to-repeat outcomes. RF demonstrates superiority in terms of immediate relief and VAS reduction, whereas GKRS offers the advantage of a non-invasive technique that does not require deep puncture.