Long-term efficacy of microvascular decompression in trigeminal neuralgia.

Journal Article (Journal Article)

Forty patients were followed for an average period of 8 1/2 years after 44 consecutive suboccipital craniotomies for trigeminal neuralgia. Among these patients, 36 had microvascular decompression (MVD) of the nerve, four had repeat trigeminal rhizotomy after MVD was not successful in controlling their pain, and four had primary trigeminal rhizotomies. Of the 36 patients undergoing MVD, 17 (47%) experienced recurrent postoperative neuralgic pain: in 11 (31%) pain recurrence was major, and in six (17%) it was minor. Among the eight patients undergoing rhizotomy, four (50%) had major pain recurrences and one (13%) had a minor recurrence, for a 63% total recurrence rate. There was a strong statistical relationship between an operative finding of arterial cross-compression of the nerve and long-term complete pain relief. Patients with other compressive pathology (related to veins or bone structures) did not on the average fare as well. Despite this, there appeared to be no point in time in the postoperative interval when the patient could be considered "cured." Major recurrences averaged 3.5% annually, and minor recurrences averaged 1.5% annually. The implications of these findings for the treatment of trigeminal neuralgia and the current understanding of the mechanism of MVD for this disorder are discussed.

Full Text

Duke Authors

Cited Authors

  • Burchiel, KJ; Clarke, H; Haglund, M; Loeser, JD

Published Date

  • July 1988

Published In

Volume / Issue

  • 69 / 1

Start / End Page

  • 35 - 38

PubMed ID

  • 2454303

International Standard Serial Number (ISSN)

  • 0022-3085

Digital Object Identifier (DOI)

  • 10.3171/jns.1988.69.1.0035


  • eng

Conference Location

  • United States