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EFFECT OF MICROVASCULAR DECOMPRESSION IN TRIGEMINAL NEURALGIA PATIENTS WITH OR WITHOUT CONSTANT PAIN

Sandell, Tiril M.D.; Eide, Per Kristian M.D., Ph.D.

Neurosurgery:
doi: 10.1227/01.NEU.0000316856.32104.65
Clinical Studies
Abstract

OBJECTIVE: To study the effect of microvascular decompression (MVD) in trigeminal neuralgia (TN) patients with or without constant pain.

METHODS: The study includes all first-time MVDs for facial pain performed by the senior author (PKE) during the 6-year period from 1999 to 2005 in the Department of Neurosurgery at the National Hospital. At the time of follow-up, pain relief was assessed using a standard mail questionnaire; those patients still having residual pain were further examined in the outpatient clinic or interviewed by phone.

RESULTS: The total study population includes 135 patients who underwent initial MVDs (67% of MVDs for TN without constant pain and 33% of MVDs for TN with constant pain). At the time of follow-up, the response rate was 95%, which provided us with 128 patients. The median observation period was 38 months (range, 12–87 mo). For episodic pain, MVD caused complete (i.e., 100%) pain relief in 78% of TN patients without constant pain and in 77% of TN patients with constant pain before MVD, and a significant pain relief (i.e., worst pain marked as 0–3 cm on a 10-cm visual analog scale) in 85 and 81%, respectively. For constant pain, MVD caused complete pain relief in 70% of the TN patients with constant pain before MVD, and significant pain relief in 77%.

CONCLUSION: In TN patients with constant pain before MVD, significant relief of episodic and constant pain was observed in 81 and 77%, respectively. Hence, the presence of constant pain should not prevent TN patients from being offered MVD.

Author Information

Department of Neurosurgery, Division of Clinical Neuroscience, The National Hospital (Rikshospitalet), Oslo, Norway

Reprint requests: Per Kristian Eide, M.D., Ph.D., Department of Neurosurgery, Division of Clinical Neuroscience, The National Hospital (Rikshospitalet), N-0027 Oslo, Norway. Email: per.kristian.eide@rikshospitalet.no

Received, August 15, 2007.

Accepted, March 28, 2008.

Copyright © by the Congress of Neurological Surgeons