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Microvascular decompression for trigeminal neuralgia in patients with multiple sclerosis
D K Resnick1, P J Jannetta, L D Lunsford
1University of Pittsburgh, School of Medicine, Department of Neurological Surgery, Pennsylvania, USA.
Surgical Neurology
|October 1, 1996
Summary
For patients with trigeminal neuralgia and multiple sclerosis (MS), partial sectioning of the trigeminal nerve offers better pain relief than microvascular decompression (MVD) alone. MVD may not provide adequate pain relief in these cases.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Trigeminal neuralgia (TN) is often treated with microvascular decompression (MVD).
- Multiple sclerosis (MS) has historically been a contraindication for MVD due to its widespread nature.
- Some patients develop MS after MVD, and managing recurrent TN in MS patients is challenging.
Purpose of the Study:
- To evaluate surgical options for trigeminal neuralgia in patients with multiple sclerosis.
- To compare the efficacy of MVD alone versus MVD with partial trigeminal nerve sectioning in MS patients.
Main Methods:
- Exploration of the cerebellopontine angle was performed on five MS patients.
- Three patients underwent MVD only.
- Two patients underwent MVD combined with partial sectioning of the trigeminal nerve.
Main Results:
- Microvascular decompression alone provided insufficient pain relief for patients with MS.
- Partial sectioning of the trigeminal nerve resulted in better pain management outcomes.
Conclusions:
- Surgical exploration and partial sectioning of the trigeminal nerve may benefit MS patients with TN symptoms.
- Microvascular decompression alone is not a reliable or adequate treatment for TN in the context of MS.