Teflon Granuloma: A Common Cause of Recurrent Trigeminal Neuralgia

BACKGROUND: Trigeminal neuralgia (TN) is a common pain syndrome of the nervous system,. Although about 90% patients who were refractory to medications could be free from pain after microvascular decompression (MVD), some patients did experience recurrence. The study aimed to analyze clinical characteristics of patients with recurrent TN, recurrence factors of TN, and prognosis after re-do MVD. METHODS: Clinical data and at least 12 months follow-up of patients with recurrent TN who underwent re-do MVD in our hospital from 2005 to 2020 were collected and analyzed. RESULTS: A total of 14 patients with recurrent TN were enrolled eventually; adhesive arachnoid membranes were found in all patients. Teflon granuloma was found in 10 patients, new neurovascular compression (NVC) in 3 patients, and vascular displacement in 1 patient. Pain disappeared in 12 patients and relieved in 2 patients, but 4 patients experienced mild facial numbness and 1 patient suffered from incision infection after re-do MVC. No serious surgery-related complications and pain recurrences were recorded. CONCLUSIONS: Teflon granuloma was the most common cause of TN recurrence in current study, new NVC was also saw in some patients. Patients with recurrent TN could get satisfactory results from re-do MVD.

Automated summary

Teflon granuloma is the most common cause of TN recurrence. New neurovascular compression (NVC) was also observed in some patients. Re-do MVD can provide satisfactory results for patients with recurrent TN.