A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression

Tushar Soni; Mayuresh Rampurkar

doi:doi:10.11648/j.ijn.20210501.15

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A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression

Tushar Soni, Mayuresh Rampurkar

Published in International Journal of Neurosurgery (Volume 5, Issue 1)

Received: 7 April 2021 Accepted: 21 April 2021 Published: 29 April 2021

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Abstract

Trigeminal neuralgia is one of the most painful conditions affecting area of face supplied by trigeminal nerve, which has a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental population. The objective of this study is to evaluate of important clinical factors about trigeminal neuralgia and analysis of outcome after micro vascular decompression. This study includes 150 cases of trigeminal neuralgia treated with micro vascular decompression in VSGH and SVP hospital, Ahmedabad over the period of 10 years. In this study, the peak incidence of Trigeminal neuralgia was in 50-69 age groups with male preponderance (male-female ratio- 1.17:1). Most common complaint was typical trigeminal neuralgic pain along one side of face over a period of 2-5 years. The right side of face and V2+V3 segment of trigeminal nerve was involved more commonly. Intraoperatively, an arterial loop compressing trigeminal nerve was found in 90% of the patients. Duration of post-operative hospitalization in maximum patients was less than 5 days (60%) and there were no postoperative complications in 96% patients. The complications noted were pseudo-meningocele (2%), persistent facial pain (1.3%), transient facial weakness (2%), meningitis (0.66%) and death (1.3%). We can conclude from this study that, trigeminal neuralgia is a very painful disease of old age with slight male preponderance. Right sided v2v3 and v3 divisions are commonly involved with arterial loop compressing trigeminal nerve being the most common pathology. Micro vascular decompression is proved to be an effective modality of surgery with high success rate and very few complications.

Published in	International Journal of Neurosurgery (Volume 5, Issue 1)
DOI	10.11648/j.ijn.20210501.15
Page(s)	19-23
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Trigeminal Neuralgia, Micro Vascular Decompression, Trigeminal Nerve, Neuralgic Pain, Pseudo-Meningocele

References

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[2]	Adams CBT. Trigeminal neuralgia: pathogenesis and treatment. Br J Neurosurg 1997; 11: 493±5.
[3]	Khan OA. Gabapentin relieves trigeminal neuralgia in multiple sclerosis patients. Neurology. 1998; 51 (2): 611–4.
[4]	Aree Jainkittivong1, Vilaiwan Aneksuk1 and Robert P. Langlais2 1 Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; 2 Department of Dental Diagnostic Science, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA doi: 10.1111/j.1741-2358.2011.00530.x Trigeminal neuralgia: a retrospective study of 188 Thai cases.
[5]	Sunil Yadav 1, Hitesh-Chander Mittal 2, Akash Sachdeva 3, Ajay Verma 4, Vikas Dhupar 5, Anita Dhupar 6Clin Exp Dent. 2015; 7 (1): e40-4. Retrospective study of patients with trigeminal neuralgia e40 Journal section: Oralfacial pain-TMJD Publication Types: Research A retrospective study of 72 cases diagnosed with idiopathic trigeminal neuralgia in indian populace.
[6]	Katheriya G, Chaurasia A, Khan N, Iqbal J. Prevalence of trigeminal neuralgia in Indian population visiting a higher dental care center in North India. Natl J Maxillofac Surg 2019; 10: 195-9.
[7]	Rai A, Kumar A, Chandra A, Naikmasur V, Abraham L. Clinical profile of patients with trigeminal neuralgia visiting a dental hospital: A prospective study. Indian J Pain 2017; 31: 94-9.
[8]	McLaughlin MR, Jannetta PJ, Clyde BL, Subach BR, Comey CH, Resnick DK. Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg 1999; 90: 1±8.
[9]	Peker S, Dinçer A, Necmettin Pamir M. Vascular compression of the trigeminal nerve is a frequent finding in asymptomatic individuals: 3-T MR imaging of 200 trigeminal nerves using 3D CISS sequences. Acta Neurochir (Wien). 2009 Sep; 151 (9): 1081-8. doi: 10.1007/s00701-009-0329-y. Epub 2009 May 5. PMID: 19415176.
[10]	Aqueel Pabaney, (2020) https://doi.org/10.18791/nsatlas.v6.ch01.1.
[11]	Kolluri S, Heros RC. Microvascular decompression for trigeminal neuralgia. A five-year follow-up study. Surg Neurol. 1984 Sep; 22 (3): 235-40. doi: 10.1016/0090-3019.
[12]	Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996 Apr 25; 334 (17): 1077-83. doi: 10.1056/NEJM199604253341701. PMID: 8598865. (84) 90005-3. PMID: 6463831.
[13]	Slettebø, H., Eide, P. K. A prospective study of microvascular decompression for trigeminal neuralgia. Acta neurochir 139, 421–425 (1997). https://doi.org/10.1007/BF01808878.
[14]	Sindou M, Leston J, Howeidy T, Decullier E, Chapuis F. Micro-vascular decompression for primary Trigeminal Neuralgia (typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients. Acta Neurochir (Wien). 2006 Dec; 148 (12): 1235-45; discussion 1245. doi: 10.1007/s00701-006-0809-2. Epub 2006 Sep 18. PMID: 16804643.
[15]	Obermann M, Yoon MS, Sensen K, et al. Efficacy of pregabalin in the treatment of trigeminal neuralgia. Cephalalgia. 2008; 28 (2): 174–81.
[16]	Debta, P, Sarode, G, Sarode, S, et al. Natural history of trigeminal neuralgia—A hospital‐based retrospective study. Oral Dis. 2020; 26: 647– 655. https://doi.org/10.1111/odi.13263.

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APA Style

Tushar Soni, Mayuresh Rampurkar. (2021). A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression. International Journal of Neurosurgery, 5(1), 19-23. https://doi.org/10.11648/j.ijn.20210501.15

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ACS Style

Tushar Soni; Mayuresh Rampurkar. A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression. Int. J. Neurosurg. 2021, 5(1), 19-23. doi: 10.11648/j.ijn.20210501.15

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AMA Style

Tushar Soni, Mayuresh Rampurkar. A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression. Int J Neurosurg. 2021;5(1):19-23. doi: 10.11648/j.ijn.20210501.15

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@article{10.11648/j.ijn.20210501.15,
  author = {Tushar Soni and Mayuresh Rampurkar},
  title = {A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression},
  journal = {International Journal of Neurosurgery},
  volume = {5},
  number = {1},
  pages = {19-23},
  doi = {10.11648/j.ijn.20210501.15},
  url = {https://doi.org/10.11648/j.ijn.20210501.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20210501.15},
  abstract = {Trigeminal neuralgia is one of the most painful conditions affecting area of face supplied by trigeminal nerve, which has a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental population. The objective of this study is to evaluate of important clinical factors about trigeminal neuralgia and analysis of outcome after micro vascular decompression. This study includes 150 cases of trigeminal neuralgia treated with micro vascular decompression in VSGH and SVP hospital, Ahmedabad over the period of 10 years. In this study, the peak incidence of Trigeminal neuralgia was in 50-69 age groups with male preponderance (male-female ratio- 1.17:1). Most common complaint was typical trigeminal neuralgic pain along one side of face over a period of 2-5 years. The right side of face and V2+V3 segment of trigeminal nerve was involved more commonly. Intraoperatively, an arterial loop compressing trigeminal nerve was found in 90% of the patients. Duration of post-operative hospitalization in maximum patients was less than 5 days (60%) and there were no postoperative complications in 96% patients. The complications noted were pseudo-meningocele (2%), persistent facial pain (1.3%), transient facial weakness (2%), meningitis (0.66%) and death (1.3%). We can conclude from this study that, trigeminal neuralgia is a very painful disease of old age with slight male preponderance. Right sided v2v3 and v3 divisions are commonly involved with arterial loop compressing trigeminal nerve being the most common pathology. Micro vascular decompression is proved to be an effective modality of surgery with high success rate and very few complications.},
 year = {2021}
}

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TY - JOUR
T1 - A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression
AU - Tushar Soni
AU - Mayuresh Rampurkar
Y1 - 2021/04/29
PY - 2021
N1 - https://doi.org/10.11648/j.ijn.20210501.15
DO - 10.11648/j.ijn.20210501.15
T2 - International Journal of Neurosurgery
JF - International Journal of Neurosurgery
JO - International Journal of Neurosurgery
SP - 19
EP - 23
PB - Science Publishing Group
SN - 2640-1959
UR - https://doi.org/10.11648/j.ijn.20210501.15
AB - Trigeminal neuralgia is one of the most painful conditions affecting area of face supplied by trigeminal nerve, which has a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental population. The objective of this study is to evaluate of important clinical factors about trigeminal neuralgia and analysis of outcome after micro vascular decompression. This study includes 150 cases of trigeminal neuralgia treated with micro vascular decompression in VSGH and SVP hospital, Ahmedabad over the period of 10 years. In this study, the peak incidence of Trigeminal neuralgia was in 50-69 age groups with male preponderance (male-female ratio- 1.17:1). Most common complaint was typical trigeminal neuralgic pain along one side of face over a period of 2-5 years. The right side of face and V2+V3 segment of trigeminal nerve was involved more commonly. Intraoperatively, an arterial loop compressing trigeminal nerve was found in 90% of the patients. Duration of post-operative hospitalization in maximum patients was less than 5 days (60%) and there were no postoperative complications in 96% patients. The complications noted were pseudo-meningocele (2%), persistent facial pain (1.3%), transient facial weakness (2%), meningitis (0.66%) and death (1.3%). We can conclude from this study that, trigeminal neuralgia is a very painful disease of old age with slight male preponderance. Right sided v2v3 and v3 divisions are commonly involved with arterial loop compressing trigeminal nerve being the most common pathology. Micro vascular decompression is proved to be an effective modality of surgery with high success rate and very few complications.
VL - 5
IS - 1
ER -

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Author Information

Tushar Soni

Department of Neurosurgery, Smt. NHL Municipal Medical College & S. V. P. Hospital, Ahmedabad, Gujarat, India
Mayuresh Rampurkar

Department of Neurosurgery, Smt. NHL Municipal Medical College & S. V. P. Hospital, Ahmedabad, Gujarat, India

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APA Style

Tushar Soni, Mayuresh Rampurkar. (2021). A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression. International Journal of Neurosurgery, 5(1), 19-23. https://doi.org/10.11648/j.ijn.20210501.15

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ACS Style

Tushar Soni; Mayuresh Rampurkar. A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression. Int. J. Neurosurg. 2021, 5(1), 19-23. doi: 10.11648/j.ijn.20210501.15

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AMA Style

Tushar Soni, Mayuresh Rampurkar. A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression. Int J Neurosurg. 2021;5(1):19-23. doi: 10.11648/j.ijn.20210501.15

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@article{10.11648/j.ijn.20210501.15,
  author = {Tushar Soni and Mayuresh Rampurkar},
  title = {A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression},
  journal = {International Journal of Neurosurgery},
  volume = {5},
  number = {1},
  pages = {19-23},
  doi = {10.11648/j.ijn.20210501.15},
  url = {https://doi.org/10.11648/j.ijn.20210501.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20210501.15},
  abstract = {Trigeminal neuralgia is one of the most painful conditions affecting area of face supplied by trigeminal nerve, which has a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental population. The objective of this study is to evaluate of important clinical factors about trigeminal neuralgia and analysis of outcome after micro vascular decompression. This study includes 150 cases of trigeminal neuralgia treated with micro vascular decompression in VSGH and SVP hospital, Ahmedabad over the period of 10 years. In this study, the peak incidence of Trigeminal neuralgia was in 50-69 age groups with male preponderance (male-female ratio- 1.17:1). Most common complaint was typical trigeminal neuralgic pain along one side of face over a period of 2-5 years. The right side of face and V2+V3 segment of trigeminal nerve was involved more commonly. Intraoperatively, an arterial loop compressing trigeminal nerve was found in 90% of the patients. Duration of post-operative hospitalization in maximum patients was less than 5 days (60%) and there were no postoperative complications in 96% patients. The complications noted were pseudo-meningocele (2%), persistent facial pain (1.3%), transient facial weakness (2%), meningitis (0.66%) and death (1.3%). We can conclude from this study that, trigeminal neuralgia is a very painful disease of old age with slight male preponderance. Right sided v2v3 and v3 divisions are commonly involved with arterial loop compressing trigeminal nerve being the most common pathology. Micro vascular decompression is proved to be an effective modality of surgery with high success rate and very few complications.},
 year = {2021}
}

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