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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.

doi: 10.1227/01.NEU.0000316856.32104.65
Clinical Studies

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.

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