A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression

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.