Repeat microvascular decompression for recurrent idiopathic trigeminal neuralgia

Nicolaas A. Bakker*, J. Marc C. van Dijk, Steven Immenga, Michiel Wagemakers, Jan D. M. Metzemaekers

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    30 Citations (Scopus)

    Abstract

    Object. Microvascular decompression (MVD) is considered the method of choice to treat idiopathic trigeminal neuralgia (TN) refractory to medical treatment. However, repeat MVD for recurrent TN is not well established. In this paper, the authors describe a large case series in which patients underwent repeat MVD for recurrent TN, focusing on outcome, risk factors, and complication rates.

    Methods. Between 1990 and 2012, a total of 33 consecutive patients underwent repeat MVD for recurrent TN at the University Medical Center Groningen. The authors performed a retrospective chart review and telephone interviews. Risk factors were analyzed by binary logistic regression analysis.

    Results. After 12 months of follow-up, 22 (67%) operations were successful, cif which 19 patients were completely free of pain without medication. With multivariate analysis significant risk factors for success were older age (OR 1.11, p <0.01) and direct absence of pain after repeat MVD (OR 25.2, p <0.01). Previous neurodestructive procedures did not influence success rates. Facial numbness occurred in 9 patients (27%), while other morbidity was minimal. There was no mortality.

    Conclusions. This study demonstrates that repeat MVD is a feasible therapeutic option with good chances of success, even in patients who have undergone neurodestructive procedures. Complication rates, particularly facial numbness, can be avoided if only a limited neurolysis is performed.

    Original languageEnglish
    Pages (from-to)936-939
    Number of pages4
    JournalJournal of Neurosurgery
    Volume121
    Issue number4
    DOIs
    Publication statusPublished - Oct-2014

    Keywords

    • microvascular decompression
    • trigeminal neuralgia
    • recurrent
    • Sweet procedure
    • pain
    • functional neurosurgery
    • RADIOSURGERY

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