Factors affecting the surgical outcome of microvascular decompression in trigeminal neuralgia
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 465-474
Abstract
Background: Microvascular decompression is an established surgical modality for treatment of trigeminal neuralgia with variable long-term success rates depending on numerous patient and disease related factors.Methods: A prospective study was done including 31 patients, aged between 18 to 74 years who underwent microvascular decompression for primary trigeminal neuralgia at our institution. Barrows neurological institute pain intensity scale and facial numbness score were used to assess outcome till 1 year follow up period.
Results: 71% patients were suffering from typical trigeminal neuralgia with involvement of both V2 and V3 divisions being the most common presentation. All patients achieved favorable outcome based on BNI pain and numbness score in the immediate post-operative period however at one year 3 patients had un-favourable pain score. Younger age, longer duration of neuralgia before surgery, involvement of all three trigeminal nerve divisions, pure venous compression and presence of focal arachnoiditis were factors associated with poor outcome.
Conclusions: MVD is a safe and effective procedure in all age groups including elderly patients with both typical and atypical symptomatology. It is seen to be effective in relieving both arterial and mixed venous neurovascular conflict especially in patients with NVC grade III severity. However, the distribution of pain in all three divisions of trigeminal nerve, pure venous compression and presence of focal arachnoiditis seem to be associated with poorer outcome.
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