[Algorithms for neurosurgical treatment of trigeminal neuralgia]

Surgery should be considered only after anticonvulsant medications have failed or if medical treatment is not well-tolerated, including in cases of asthenia or drowsiness. In most reference centers, consensus is that MVD is the first option when patients are in good health. Percutaneous lesioning operations or radiosurgery are preferable in patients with adverse co-morbidity or those who are not willing to undergo open surgery.