Trigeminal neuralgia microvascular decompression eleven years experience at L G H, Lahore. | [Pakistan Journal of Neurological Surgery • 2003]

Author(s):

1. Syedul-Abrar: Department of Neurosurgery, Lahore General Hospital, Lahore, Pakistan

2. Abdul-Hameed: Department of Neurosurgery, Lahore General Hospital, Lahore, Pakistan

3. Muhammad Anwar: Department of Neurosurgery, Lahore General Hospital, Lahore, Pakistan

4. Naveed Ashraf: Department of Neurosurgery, Lahore General Hospital, Lahore, Pakistan

5. M. Ashfaq: Department of Neurosurgery, Lahore General Hospital, Lahore, Pakistan

6. Muhammad Khalid: Department of Neurosurgery, Lahore General Hospital, Lahore, Pakistan

7. Ibrahim Khalil: Department of Neurosurgery, Lahore General Hospital, Lahore, Pakistan

8. Muhamad Akmal: Department of Neurosurgery, Lahore General Hospital, Lahore, Pakistan

Abstract:

Trigeminal Neuralgia is a paroxysmal lancinating unilateral facial pain lasting for a few seconds to minutes. The various numbers of surgical procedures for obtaining pain relief are being practiced like alcohol injection, Rhizotomy, Balloon compression & Percutaneous trigeminal thermocoagulation apart from pharmacotherapy. This very fact proves that no single treatment is entirely successful. So micro vascular decompression (MVD) is the procedure of choice in those cases which are not responding to medical therapy. MVD has excellent results with limited morbidity. A study of 190 cases is being presented. This study was carried out in the Department of Neurosurgery Unit II Lahore General Hospital From May 1991 to April 2002. There was slight female predominance, 96 (51%) female and 94 (49%)males. Right side was involved in !30 (68%) cases and left side was involved in 60 (32%) cases. Majority of patients 176 (93%) cases presented during 4th , 5th, 6th and 7th decade (31-70 years) of life. Offending vessel was single arterial loop in 134 (72%) cases, double arterial loop in 27 (14%), both arterial and venous loop in 20 (11%) and only venous loop in 6 (3%) cases, Offending arterial loop was located in medical position in 122(59%) cases. Lateral in 44 (21%) cases and superior in 17(82) cases Meshed autogenous muscle graft was used in all cases of MVD Pain relief was immediate excellent in 173 (19%) cases, Good in 13 (7%) cases and failute in 4(2%). CSF rhinorrhea 2 cases aseptic meningitis 4 cases and collection it CSF in the wound 4 cases. Complications occurred in 26 cases. Most of them were transient and manageable. The complications were transient vertigo 10 cases, vomiting 4 cases. Mortality was observed in only 1.2% cases. The conclusion is that MVD is the procedure of choice for treating Trigeminal Neuralgia in drug resistant failed medical therapy cases. Autogenous meshed muscle graft is very effective as an implant between 5th Nerve and offending vessels.

Page(s): 3-12

DOI: DOI not available

Published: Journal: Pakistan Journal of Neurological Surgery, Volume: 7, Issue: 1, Year: 2003

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