MVD as the First Line Therapy after Failed Medical Treatment; for Idiopathic Trigeminal Neuralgia

Authors

  • Attiq-ur- Rehman Department, of Neurosurgery Postgraduate Medical Institute Lahore General Hospital
  • ABDULLAH HAROON Department of Neurosurgery Unit – I
  • ASIF SHABBIR Department of Neurosurgery Unit – I
  • Abdul Majid Department of Neurosurgery Unit – I
  • Shahid Hameed Department of Neurosurgery Unit – I

Keywords:

Idiopathic trigeminal neuralgia, Microvascular decompression, Fascial Pain.

Abstract

Objective: To analyze the outcome of MVD as a first choice therapy when medical treatment has failed for the definitive management of Idiopathic Trigeminal Neuralgia.
Material and Methods:
Study was conducted at the Department of Neurosurgery PGMI / Lahore General Hospital, Lahore. This was a prospective observational case series from January 2007 to December 2008, 50 selected patients of Idiopathic Trigeminal Neuralgia diagnosed after radiological and clinical exclusion of secondary causes of Neuralgia presenting in whom medical management had failed were offered MVD as the first Intervention. All the patients were followed for one year post-operatively.
Results: Mean age was 59.2 years and minimum age 47 year and maximum 72 years. There was 16 males (32.0%) and females were 34 (68.0%). Male to female ratio was 1: 2.16. In 15 (30.0%) patients facial pain was on left side and 35 (70.0%) patients had right sided pain. V1 was found in 1 (2.0%) patient, V3 in 2 (4.0%) pati-ents, V1 and V2 in 2 (4.0%) patients, V1-3 in 17 (34.0%) patients, V2,3 in 28 (56.0%) patients. An Arterial loop was found in 37 (74.0%) patients as the compressing agent and a Vein only in 4 (8.0%) patients. Mixed artery and vein in 8 (16.0%) patients. Thick arachnoid was the compressing agent in 1 (2.0%) patient. Out of 50 patients 46 (92.0%) had Excellent outcome, 3 (6.0%) patients had Good outcome, 1 (2.0%) patient was in Fair outcome group. No patients were in Bad and Failure outcome groups.
Conclusion: Microvascular Decompression of trigeminal nerve is a safe and first choice therapy when medical treatment has failed for the definitive management of Idiopathic Trigeminal Neuralgia in otherwise medically fit patients provided Surgeon has adequate experience of performing the procedure.

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Published

2018-10-09

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Vol. 16 No. 1 (2012): January-June

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Original Articles

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