Surgeries:

Microvascular Decompression

Trigeminal Neuralgia is a rare type of facial pain characterised by severe, intermittent, sharp, shooting, electric shock pain which is triggerable by eating, drinking, touch, wind. There is no prior history of injury, shingles or surgery which may cause other types of facial pain.  It typically responds to drugs like Tegretol or Carbamazepine and is unlikely to respond to typical pain relieving medications.

In some patients, but not all, the cause of trigeminal neuralgia may be a blood vessel compressing the trigeminal nerve in the brain and a MRI brain scan will usually disclose this.

When trigeminal neuralgia pain becomes refractory to medical therapy and there is a blood vessel compressing the nerve microvascular decompression surgery or MVD may be recommended in patients who are fit for cranial surgery.

The rationale for MVD is to directly treat the underlying cause of trigeminal neuralgia and theoretically prevent the pain from returning in the long term, although this can occur.

Surgery involves a general anaesthetic, an incision behind the ear and opening into the skull to explore the trigeminal nerve from the brain stem and free it from compression using Teflon felt which acts as cushion between the nerve and the vessel. Risks include injury to nerves and blood vessels, infection and remotely stroke and death. The success of surgery depends on the nature of the facial pain (lanciating intermittent pain more likely to improve than constant dull pain) and what is found at surgery (artery vs vein vs no compression).

Most patients are in hospital for 4-7 days and will take a few weeks to fully recover from surgery and should gradually reduce their pain medication.

Routine follow up visit is in 6 weeks.

Microvascular Decompression

Trigeminal Neuralgia is a rare type of facial pain characterised by severe, intermittent, sharp, shooting, electric shock pain which is triggerable by eating, drinking, touch, wind. There is no prior history of injury, shingles or surgery which may cause other types of facial pain.  It typically responds to drugs like Tegretol or Carbamazepine and is unlikely to respond to typical pain relieving medications.

In some patients, but not all, the cause of trigeminal neuralgia may be a blood vessel compressing the trigeminal nerve in the brain and a MRI brain scan will usually disclose this.

When trigeminal neuralgia pain becomes refractory to medical therapy and there is a blood vessel compressing the nerve microvascular decompression surgery or MVD may be recommended in patients who are fit for cranial surgery.

The rationale for MVD is to directly treat the underlying cause of trigeminal neuralgia and theoretically prevent the pain from returning in the long term, although this can occur.

Surgery involves a general anaesthetic, an incision behind the ear and opening into the skull to explore the trigeminal nerve from the brain stem and free it from compression using Teflon felt which acts as cushion between the nerve and the vessel. Risks include injury to nerves and blood vessels, infection and remotely stroke and death. The success of surgery depends on the nature of the facial pain (lanciating intermittent pain more likely to improve than constant dull pain) and what is found at surgery (artery vs vein vs no compression).

Most patients are in hospital for 4-7 days and will take a few weeks to fully recover from surgery and should gradually reduce their pain medication.

Routine follow up visit is in 6 weeks.