Effectiveness of Microvascular Decompression for the Treatment of Idiopathic Trigeminal Neuralgia

Objective: To review the efficacy and safety of microvascular decompression for idiopathic trigeminal neuralgia.Materials and Methods: This descriptive cross sectional study was conducted at Neurosurgery Department of Naseer teaching Hospital, Peshawar from 1st January 2016 to 31st December2017. All patients fulfilling the inclusion criteria undergo micro vascular decompression (MVD). MRI brain was done in all patient to exclude the secondary cause. Patients were examined on 5th post operative day and clinical finding documented. Outcome of surgery is determined by visual analogue scale in which Pain was graded as no pain (0 score), mild (1 – 3), moderate (4 – 7), severe (8 – 10) to see the pain relief.Results: Forty four patients were operated for trigeminal neuralgia (TN). There were 18 (41%) males and 26 (59%) females. Mean age was 33 years. Entry zone of trigeminal nerve was point of conflict in 33 (75%) patients. The mandibular division (V2) was involved in 26 (59%) patients, followed by maxillary division (V3) in 13 (29.54%) patients and ophthalmic division (V1) in 5 (11.36%) cases. At fifth postoperative day, status of pain relief was analyzed amongst 44 patients and it was observed that 37 (84.09%) patients had no pain, 5 (11.36%) had mild pain and 1 (2.27%) had severe pain. Postoperative complications were observed as nausea and vomiting in 15 (34.09%) patients, Diplopia in 6 (13.63%), facial palsy in 6 (13.63%), CSF leak in 5 (11.36%), mild deafness in 5 (11.36%), wound infection in 4 (9.09%) and cerebellar infarction in 3 (6.81%) patients.Conclusion: Microvascular decompression is an effective surgical option for trigeminal neuralgia refractory to medical treatment