MICROSURGICAL TREATMENT OF TRIGEMINAL NEU RALGIA - REVIEW OF 50 CASES

The authors present a study of 50 patients with trigeminal neuralgia t reated by posterior fossa microsurgery. Microvascular decompression of the trigeminal nerve was performed in 48 patients. In 2 cases no neur o-vascular compression was found, and a partial rhizotomy was carried out. In 98% of the cases there was postoperative abolition of the pain . Two cases of wound infection and three CSF fistulas were the operati ve complications. These patients were reoperated and cured. Twenty fiv e patients were reviewed between 13 months and 8 years after surgery. Twenty one remained painfree without any drug, 3 were painfree taking 200 to 400 mg Carbamazepineper day, and I patient was reoperated after two years without pain because of recurrence of the neuralgia. There was no mortality or major morbidity in this series. Our results and th e literature concerning this method are discussed in this article. In conclusion, microvascular decompression may be indicated in a large nu mber of patients with essential trigeminal neuralgia due to its excell ent pain control, no mortality and low morbidity.