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Tony Whitworth, M.D. - The three categories of trigeminal neuralgia surgical procedures |
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Bruce E. Pollock, M.D. - Comparing Classic trigeminal neuralgia surgical options |
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Konstantin Slavin, M.D. - Importance of understanding trigeminal neuralgia surgeries available |
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Mark E. Linskey, M.D. - Should I consider a minimally invasive trigeminal neuralgia surgery approach first? |
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Mark E. Linskey, M.D. - Questions to ask a neurosurgeon about trigeminal neuralgia |
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K. Singh Sahni, M.D., F.A.C.S. - Questions to ask a neurosurgeon about trigeminal neuralgia |
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Tony Whitworth, M.D. - Will insurance cover my trigeminal neuralgia surgical procedure? |
Surgical Considerations - Trigeminal Neuralgia
Surgical indications for classic trigeminal neuralgia (TN) should only be considered after a TN medication trial. It may take trying a few medications and adjusting dosages before a decent trial has been given a chance to work.
If a classic TN patient can not tolerate the side effects of medication that works, then surgical treatment may be appropriate. Initially, approximately 10% of TN patients will not be able to tolerate the medication for a variety of reasons.
After a TN medication trial, some patients may decide that they just don’t want to take medication and pursue surgery immediately.
Most neurosurgeons consider the microvascular decompression the “gold standard” for surgical treatment of trigeminal neuralgia. However, not all patients are good microvascular decompression candidates due to their health and possibly their age so other surgical treatments should be carefully evaluated for this set of patients.
Many neurosurgeons believe their trigeminal neuralgia patients who have microvascular decompression surgery within seven to eight years of being diagnosed with a classic case of trigeminal neuralgia have better surgical outcomes with a higher success percentage than patients who delay surgery longer. Some neurosurgeons believe the quicker a patient is diagnosed with trigeminal neuralgia and has a microvascular decompression, the higher their success rate will be since they are stopping destruction of the trigeminal nerve quicker than those who wait for years to have the surgery.
Comparison of posterior fossa exploration and stereotactic radiosurgery in patients with previously nonsurgically treated idiopathic trigeminal neuralgia
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.7
Evaluation of Surgical Procedures for Trigeminal Neuralgia
How to treat: Trigeminal neuralgia
http://student.bmj.com/issues/04/01/education/16.php
Perioperative and long-term operative outcomes after surgery for trigeminal neuralgia: microvascular decompression vs percutaneous balloon ablation
Peripheral and Gasserian Ganglion-Level Procedures for the Treatment of Trigeminal Neuralgia.
http://www.clinicalpain.com/pt/re/clnjpain/abstract.00002508-200201000-00005.htm
A prospective cost-effectiveness study of trigeminal neuralgia surgery
Recurrent or refractory trigeminal neuralgia after microvascular decompression, radiofrequency ablation, or radiosurgery
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.13
Treatment of idiopathic trigeminal neuralgia: comparison of long-term outcome after radiofrequency rhizotomy and microvascular decompression
Trigeminal Neuralgia - eMedicine
http://www.emedicine.com/med/topic2899.htm
Trigeminal Neuralgia – “TN”
http://www.cwnsurgery.com/CWN/Trigem_Neur.html
Trigeminal Neuralgia FAQ
http://neurosurgery.medschool.ucsf.edu/patient_care/nerve_faq.html
Trigeminal Neuralgia Treatment - Mayo Clinic
http://www.mayoclinic.org/trigeminal-neuralgia/treatment.html
Organizations
Trigeminal Neuralgia Association
http://www.fpa-support.org
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