Bruce E. Pollock, M.D. - Surgical options for Multiple Sclerosis patients with trigeminal neuralgia
	K. Singh Sahni, M.D., F.A.C.S. - Surgical options for Multiple Sclerosis patients with trigeminal neuralgia
	Jeffrey A. Brown, M.D. - Multiple Sclerosis: A difficult problem
	John G. Golfinos, M.D., A.B. - Multiple Sclerosis patients with trigeminal neuralgia - surgical treatments at NYU

Surgical Considerations - Multiple Sclerosis

When a Multiple Sclerosis (MS) patient has facial pain, the surgical considerations are a bit different from those who just have classic trigeminal neuralgia (TN).

In the past, the belief was that myelin sheath damage was due to disease process, so microvascular decompression (MVD) was not considered an option.  Recent MVD studies have included some MS/TN patients got better after a microvascular decompression but post MVD excellent pain relief was significantly less for the MS/TN patients (only 39% in one study) .

MS/TN patients should consider Radiosurgery and all three percutaneous procedures as possible surgical treatments even though they are considered destructive treatments.  Keep in mind the chance of MS/TN patients face pain returning after a surgical treatment is greater than for classic TN patients.  However, these destructive procedures can be repeated.

One Size Does Not Fit All:  Choosing a Surgical Treatment Strategy for Trigeminal Neuralgia

Organizations

Multiple Sclerosis Association of America
http://www.msassociation.org

Multiple Sclerosis Foundation
http://www.msfocus.org

Multiple Sclerosis International Federation
http://www.msif.org/en

National Multiple Sclerosis Society
http://www.nationalmssociety.org

Trigeminal Neuralgia Association
http://www.fpa-support.org/