gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Operative findings and outcome of microvascular decompression for trigeminal neuralgia in patients with multiple sclerosis

Meeting Abstract

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  • Gökce Hatipoglu Majernik - Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
  • Joachim K. Krauss - Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.16.02

doi: 10.3205/17dgnc470, urn:nbn:de:0183-17dgnc4705

Published: June 9, 2017

© 2017 Hatipoglu Majernik et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Trigeminal neuralgia (TN) might occur in patients with multiple sclerosis (MS). Although these patients have typical attacks they are often not considered as candidates for microvascular decompression (MVD). Optimal treatment in this group patients is unclear. Here we examine surgical findings and the results of MVD in multiple sclerosis.

Methods: Thirteen patients with MS affected by trigeminal neuralgia underwent MVD. All patients had a magnetic resonance imaging (MRI), which showed radiological findings of MS, before surgery. Results were assessed by clinical follow-up and periodic phone surveys. Mean follow-up was 34 months.

Results: There was no surgery related morbidity or mortality. All patients became refractory to medication preoperatively. Intraoperative findings indicated scar tissue at the trigeminal entry zone (11 patients), arterial contact (6 patients) and venous contact (7 patients). Initial postoperative pain relief was observed in 10 out of 11 patients. One patient had partial pain relief. In the follow-up 7 patients had pain relief, 3 had partial relief which were controlled with medication and 3 had recurrence. Two patients underwent a second MVD because of tefloma. One patient had 2 MVDs and afterwards percutaneous radiofrequency rhizotomy (PRR) because of pain persistence.

Conclusion: MVD initially provides good pain relief and in the long term follow up complete and partial pain relief was achieved in the 10 of 13 patients. Moreover, the intraoperative findings show neurovascular compression in all patients which was not determined by all patients in preoperative MRIs. Therefore, we suggest that although the success rate in this patients group is relatively lower compared to idiopathic TN patients group, MVD should be a seriously considered treatment option for TN in patients with MS.