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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
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Trigeminal neuralgia management after microvascular decompression surgery: two case reports.

Victor Hwang1, Erick Gomez-Marroquin2, Reyes Enciso3

  • 1Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA.

Journal of Dental Anesthesia and Pain Medicine
|January 7, 2021
PubMed
Summary

Trigeminal neuralgia (TN) pain can persist after microvascular decompression (MVD) surgery. This case report highlights the need for pharmacological therapy reintroduction in such cases, emphasizing ongoing research for effective treatment strategies.

Keywords:
CarbamazepineCase ReportsGabapentinMicrovascular Decompression SurgeryTrigeminal Neuralgia

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Area of Science:

  • Neurology
  • Neurosurgery

Background:

  • Trigeminal neuralgia (TN) is a chronic neuropathic pain condition.
  • Anticonvulsants like carbamazepine are first-line treatments.
  • Microvascular decompression (MVD) surgery is an option for refractory cases, with an 83% success rate.

Observation:

  • Two patients experienced persistent neuropathic pain after MVD surgery.
  • Recurrent TN after MVD affects approximately one-third of patients.
  • Reintroduction of pharmacotherapy was necessary for pain management in these cases.

Findings:

  • Persistent pain post-MVD necessitates alternative treatment strategies.
  • Pharmacological therapy can be reintroduced effectively after MVD failure.
  • MVD is invasive, requiring hospitalization.

Implications:

  • Further research is needed on the efficacy of subsequent medication therapies after MVD.
  • Recurrent TN management requires exploring various treatment protocols.
  • This case report underscores the importance of individualized treatment plans for TN patients.