Percutaneous balloon compression shows initial pain relief in multiple sclerosis-related trigeminal neuralgia

BACKGROUND: Multiple sclerosis (MS) is a secondary cause of trigeminal neuralgia (TN). The prevalence of TN caused by MS (MS-TN) is 20 times higher than that of other causes. Along with pharmacological treatments, several other options are available for MS-TN patients, such as percutaneous balloon compression (PBC). This study aimed to evaluate the clinical outcomes and complications of PBC in patients with MS-TN. METHODS: We conducted a systematic literature search on April 7, 2025, to identify studies reporting clinical outcomes in patients with MS-TN and PBC. RESULTS: Twelve studies comprising 386 patients met inclusion criteria. At the initial follow-up, the pooled pain-free rate was 65% (95% CI: 40%-86%) and the pooled adequate pain relief rate was 91% (95% CI: 81%-98%). At the subsequent follow-up, pooled estimates were 33% (95% CI: 16%-52%) for pain freedom and 77% (95% CI: 46%-98%) for adequate pain relief. Across studies, the pooled complication rate after PBC in MS-TN was 16% (95% CI: 10%-23%). CONCLUSIONS: PBC is an effective and relatively safe treatment option for managing MS-TN patients. It shows promising immediate pain relief and can be considered for patients needing quick pain reduction. Future studies should directly compare PBC with other minimally invasive treatments using large datasets to identify the best option for MS-TN patients.