Typical versus atypical trigeminal neuralgia and other factors that may affect results of neurosurgical treatment

摘要

In this issue of WORLD NEUROSURGERY, Zhang et al. review their results of treating 154 consecutive patients with trigeminal neuralgia (without a defined cause such as brain tumor or multiple sclerosis) with pure microvascular decompression (MVD). Factors associated with complete pain relief without medications after 5 years were typical symptoms, preoperative magnetic resonance imaging (MRI) indicating vessel compression, and obvious vessel compression found at operation, which were present in 64%, 64%, and 53% of patients. Initial complete pain relief and 5-year complete pain relief were seen in 87% and 80% of patients with typical trigeminal neuralgia and 79% and 54% of patients with atypical trigeminal neuralgia. A prior ablative procedure did not influence the outcome after MVD. There were no major complications.