Surgical Considerations - Trigeminal Neuropathic Pain

Since trigeminal neuropathic pain (TNP) is a result of damage to the nerve, generally, microvascular decompression is not done because it has proven to be effective in less than 50% of these patients.  Most neurosurgeons advise against any surgery which would further injure the nerve.  Destructive surgeries include radiosurgery, glycerol injections, balloon compression and radiofrequency rhizotomy.  Neurostimulation is the only current surgical procedures available that is not harmful to the nerve.  Neurostimulation pain relief for TNP patients’ average 50% and this percentage appears to be going up.

EFNS guidelines on neurostimulation therapy neuropathic pain

Neurostimulation Surgical Treatments for Facial Neuralgias
http://facial-neuralgia.org/treatments/surgical/neurostimulation.html

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