Abstract
Repeat Microvascular Decompression for Trigeminal Neuralgia After Initial Microvascular Decompression: Three Cases and Literature Review
Highlights
Trigeminal neuralgia (TN) is a debilitating disorder manifesting as intense lancinating pain in in the distribution of the trigeminal nerve [1]
Microvascular decompression (MVD) of the trigeminal nerve has become the first choice for patients with TN refractory to medication as it is an effective treatment option with initial pain relief reported as high as 98% [3,4,5]
All 3 cases were treated with repeat MVD after conservative treatment had failed
Summary
Trigeminal neuralgia (TN) is a debilitating disorder manifesting as intense lancinating pain in in the distribution of the trigeminal nerve [1]. Pharmacological treatment with medication such as carbamazepine is first line of therapy. Microvascular decompression (MVD) of the trigeminal nerve has become the first choice for patients with TN refractory to medication as it is an effective treatment option with initial pain relief reported as high as 98% [3,4,5]. Longer follow-up post MVD shows ongoing risks of recurrence several years post operatively, with Matsushima reporting a 17.1% recurrence rate at 2 years, Barker reporting 30% at 6.2 years and Burchiel reporting 47% at 8.5 years [6,7,8]. The long-term efficacy of MVD remains significantly higher than percutaneous neuro-ablative techniques with patient undergoing percutaneous rhizotomy having a recurrence rate of 75% within 5 years [9]
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