Microvascular decompression for idiopathic trigeminal neuralgia: ultimate solution to the management dilemma

ABSTRACT

Idiopathic Trigeminal Neuralgia is one of the most distressing craniofacial pain syndromes and micro vascular decompression is claimed to be the only best treatment option. The objectives of the study were to analyze the theory of neurovascular conflict as the basic pathology and prove the ineffectiveness of ablative procedures. A prospective observation study was carried out on 110 consecutive patients of idiopathic trigeminal neuralgia who went under micro vascular decompression. Clinical presentations and operative findings were recorded, analyzed and statistically correlated. Speical note was made of the previous interventions. All cases of secondary trigeminal neuralgia were excluded with the help of MRI brain. The result showed that in 90% cases superior cerebellar artery was the cause of compression on the root entry zone. It was concluded from this study that basic cause of the idiopathic trigeminal neuralgia is a vascular compression of the trigeminal nerve near its root entry zone and micro vascular decompression is the only best treatment option available at present. Moreover, correct interpretation of the symptoms is essenital to avoid inappropriate intervention