[Microsurgical treatment of trigeminal neuralgia. A study of 50 cases]

The authors present a study of 50 patients with trigeminal neuralgia treated by posterior fossa microsurgery. Microvascular decompression of the trigeminal nerve was performed in 48 patients. In 2 cases no neuro-vascular compression was found, and a partial rhizotomy was carried out. In 98% of the cases there was postoperative abolition of the pain. Two cases of wound infection and three CSF fistulas were the operative complications. These patients were reoperated and cured. Twenty five patients were reviewed between 13 months and 8 years after surgery. Twenty one remained painfree without any drug, 3 were painfree taking 200 to 400 mg Carbamazepineper day, and 1 patient was reoperated after two years without pain because of recurrence of the neuralgia. There was no mortality or major morbidity in this series. Our results and the literature concerning this method are discussed in this article. In conclusion, microvascular decompression may be indicated in a large number of patients with essential trigeminal neuralgia due to its excellent pain control, no mortality and low morbidity.