Functional outcome of Microvascular Decompression for Trigeminal Neuralgia

  • IHSAN ULLAH Department of Neurosurgery, Medical Teaching Institution, Lady Reading Hospital, Peshawar
  • KHALID KHANZADA Department of Neurosurgery, Medical Teaching Institution, Lady Reading Hospital, Peshawar
  • MUSAFIR ALAM Department of Neurosurgery, Medical Teaching Institution, Lady Reading Hospital, Peshawar
  • HAMEED ULLAH Department of Neurosurgery, Medical Teaching Institution, Lady Reading Hospital, Peshawar
Keywords: Trigeminal neuralgia, Microvascular decompression, Borrow neurological institute pain scale

Abstract

Objective: To know functional outcome of microvascular decompression in trigeminal neuralgia.
Materials and Methods: This prospective study was conducted in the Department of Neurosurgery Lady Reading Hospital Peshawar from July 2014 to Dec. 2017. Patients with idiopathic trigeminal neuralgia with failed medical treatment were included in this study. A Barrow Neurological Institute pain score was calculated for all patients’ pre and post operatively. Microvascular decompression was done in all cases and follow up done in the outpatient department of all operated cases.
Results: Thirty six patients were included in the study and operated for trigeminal neuralgia. Pre-operatively 20 (55.5%) patients had a score of 5 and 16 (44.4%) had a score of 4. Postoperatively, at the last clinic follow up, 18 patients (48.6%) had a score of 1 while 15 (37.8%) had a score of 3 and 3 (8.1%) had a score of 4. Complication developed in nine cases which included cerebrospinal fluid leak (3 patients), 1 patient hearing loss, 2 patients developed wound infection, 1 patient meningitis and cerebellar hematoma in 1 patient.
Conclusion: Good preoperative workup in the form of history, physical examination, radiological workup and microsurgical techniques are pivotal for a successful outcome. Microvascular decompression is currently a safe and effective treatment option for patients having trigeminal neuralgia not responding to medical management.

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Published
2019-06-04
Section
Original Article