Tony Whitworth, M.D.
Department of Neurological Surgery
UT Southwestern Medical Center
5303 Harry Hines Blvd.
4th Floor, Suite 100
Dallas, TX 75390-9167
214-645-2300
http://www.utsouthwestern.edu/patientcare/doctor/findphysician/profile/0,0,61027_Dr_Louis_Whitworth_MD_&fpSB=lName&fpNR=50&fpJump.html
Transcript: If a microvascular decompression fails, what’s next?
In my practice at UT Southwestern, I often see patients that have previously undergone a microvascular decompression for their trigeminal neuralgia. While initially the procedure was successful, they unfortunately have a recurrence of their symptom down the road whether it be six months or a few years later.
They come to me seeking advice on what the next step should be. For those patients, I always like to start back at square one. First, I like to know is their pain still classic for trigeminal neuralgia. Is it in the same location that it was before? Does it have the same quality as it did before? Has anything changed since their operation? Next, I will often get a high resolution three tesla MRI scan of their trigeminal nerve to look for any evidence of on-going vascular compression. Once I have that information, I am better able to counsel them whether I think that a reexploration of the nerve would be worthwhile or whether it would be better to consider one of the other treatments such as percutaneous rhizotomy or Gamma Knife Radiosurgery.