Long-term follow-up of microvascular decompression for management of trigeminal neuralgia

Abstract

Background Trigeminal neuralgia (TN) is mostly caused by neurovascular compression of the trigeminal nerve and the root entry zone at the brain stem. Microvascular decompression (MVD) has been established as a standard treatment for trigeminal neuralgia in patients not adequately controlled by medications. Objectives Reporting the long-term outcome of MVD in our group of patients with follow-up period equal to or more than five years. Patients and methods Twenty-one patients operated by MVD for TN were followed up for at least five years, they were evaluated describing the patient criteria and operative findings, complications, and the long-term clinical outcome. Results Sixteen of the twenty-one patients had complete pain relief maintained for up to five years and three of them up to eight years. Two patients had significant improvement but with mild occasional pain not requiring medications only one of them had his occasional pain maintained till five years, three patients experienced persistent pain which was still there after five years one of them showed mild improvement in his pain after one year of follow-up. Complications were mild and/or transient most frequent were headache nausea and dizziness. Conclusion In the long-term follow-up, microvascular decompression still maintains its clinical benefit with most patients still pain free after at least five years and up to eight years. It is safe procedures and should be considered in every patient with failed medical treatment.