Trigeminal Neuralgia Surgery (Microvascular Decompression)

Initially, treatment for trigeminal neuralgia includes medications (anti-seizure drugs such as Carbamazepine or gabapentin or muscle-relaxing agents such as baclofen etc. or complementary approaches (like meditation, yoga, acupuncture, low impact exercise etc.). But as it is a progressive disorder, medications soon become ineffective or may start showing side effects. In such cases, neurosurgical procedures like Microvascular Decompression should be considered that relieve the nerve pressure.

Microvascular Decompression

Microvascular decompression is a highly effective surgical method that mainly addresses the source of neuralgia by treating neurovascular disabilities associated with spasm and facial pain.

Method of Microvascular Decompression

The surgery is performed under general or local anaesthesia and involves relocating or removing blood vessels that are in contact with the trigeminal root. Through an incision behind the ear on the side of pain, surgeon enters the endoscope through a small hole in the skull. Any artery that is in contact with the trigeminal nerve is moved away from the nerve, and a pad is placed between the nerve and the arteries. In case, a vein is compressing the nerve, it may be removed as well. In some rare cases, a part of the trigeminal nerve (neurectomy) may be cut during this procedure if arteries aren’t pressing on the nerve.

This provides relief to the patient from the symptoms of neuralgia. A follow-up after 2-3 months is usually required after surgery.

Advantages of Microvascular Decompression

  • Successfully eliminates or reduces pain in most of the cases

  • Provides rapid & long-term relief from pain

  • Is a safe and flexible technique

  • Low risk of recurrence



Endoscopic Trigeminal Neuralgia surgery

Endoscopic Trigeminal Neuralgia surgery

Risks of Microvascular Decompression

The procedure does have some risks that may include any of the following:

  • Decreased hearing

  • Facial weakness

  • Facial numbness

  • Seizures

  • Nerve damage

  • Stroke etc.

Microvascular decompression can successfully eliminate or reduce pain in most of the cases, but pain can recur in some people. Most people who have this procedure have no facial numbness afterward.