Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 cases
Abstract Background Microvascular decompression (MVD) is the first choice in patients with classic trigeminal neuralgia (TGN) that could not be sufficiently controlled by pharmacological treatment. However, neurovascular conflict (NVC) could not be identified during MVD in all patients. To describe...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-022-01469-3 |
| _version_ | 1798026159209840640 |
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| author | Juan Li Min Zhou Yuhai Wang Sze Chai Kwok Jia Yin |
| author_facet | Juan Li Min Zhou Yuhai Wang Sze Chai Kwok Jia Yin |
| author_sort | Juan Li |
| collection | DOAJ |
| description | Abstract Background Microvascular decompression (MVD) is the first choice in patients with classic trigeminal neuralgia (TGN) that could not be sufficiently controlled by pharmacological treatment. However, neurovascular conflict (NVC) could not be identified during MVD in all patients. To describe the efficacy and safety of treatment with aneurysm clips in these situations. Methods A total of 205 patients underwent MVD for classic TGN at our center from January 1, 2015 to December 31, 2019. In patients without identifiable NVC upon dissection of the entire trigeminal nerve root, neurapraxia was performed using a Yasargil temporary titanium aneurysm clip (force: 90 g) for 40 s (or a total of 60 s if the process must be suspended temporarily due to bradycardia or hypertension). Results A total of 26 patients (median age: 64 years; 15 women) underwent neurapraxia. Five out of the 26 patients received prior MVD but relapsed. Immediate complete pain relief was achieved in all 26 cases. Within a median follow-up of 3 years (range: 1.0–6.0), recurrence was noted in 3 cases (11.5%). Postoperative complications included hemifacial numbness, herpes labialis, masseter weakness; most were transient and dissipated within 3–6 months. Conclusions Neurapraxia using aneurysm clip is safe and effective in patients with classic TGN but no identifiable NVC during MVD. Whether this method could be developed into a standardizable method needs further investigation. |
| first_indexed | 2024-04-11T18:30:48Z |
| format | Article |
| id | doaj.art-50a6103499b443bdb2496d8758c3fe17 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-11T18:30:48Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-50a6103499b443bdb2496d8758c3fe172022-12-22T04:09:26ZengBMCBMC Surgery1471-24822022-01-012211510.1186/s12893-022-01469-3Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 casesJuan Li0Min Zhou1Yuhai Wang2Sze Chai Kwok3Jia Yin4Department of Neurosurgery, Shanghai Tenth People’s Hospital, Tongji UniversityDepartment of Neurosurgery, Bengbu First People’s HospitalDepartment of Neurosurgery, 904 Hospital of PLAShanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics Ministry of Education, School of Psychology and Cognitive Science, East China Normal UniversityDepartment of Neurosurgery, Shanghai Tenth People’s Hospital, Tongji UniversityAbstract Background Microvascular decompression (MVD) is the first choice in patients with classic trigeminal neuralgia (TGN) that could not be sufficiently controlled by pharmacological treatment. However, neurovascular conflict (NVC) could not be identified during MVD in all patients. To describe the efficacy and safety of treatment with aneurysm clips in these situations. Methods A total of 205 patients underwent MVD for classic TGN at our center from January 1, 2015 to December 31, 2019. In patients without identifiable NVC upon dissection of the entire trigeminal nerve root, neurapraxia was performed using a Yasargil temporary titanium aneurysm clip (force: 90 g) for 40 s (or a total of 60 s if the process must be suspended temporarily due to bradycardia or hypertension). Results A total of 26 patients (median age: 64 years; 15 women) underwent neurapraxia. Five out of the 26 patients received prior MVD but relapsed. Immediate complete pain relief was achieved in all 26 cases. Within a median follow-up of 3 years (range: 1.0–6.0), recurrence was noted in 3 cases (11.5%). Postoperative complications included hemifacial numbness, herpes labialis, masseter weakness; most were transient and dissipated within 3–6 months. Conclusions Neurapraxia using aneurysm clip is safe and effective in patients with classic TGN but no identifiable NVC during MVD. Whether this method could be developed into a standardizable method needs further investigation.https://doi.org/10.1186/s12893-022-01469-3Trigeminal neuralgiaMicrovascular decompressionOffending vesselneurapraxia |
| spellingShingle | Juan Li Min Zhou Yuhai Wang Sze Chai Kwok Jia Yin Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 cases BMC Surgery Trigeminal neuralgia Microvascular decompression Offending vessel neurapraxia |
| title | Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 cases |
| title_full | Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 cases |
| title_fullStr | Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 cases |
| title_full_unstemmed | Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 cases |
| title_short | Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 cases |
| title_sort | neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression a retrospective analysis of 26 cases |
| topic | Trigeminal neuralgia Microvascular decompression Offending vessel neurapraxia |
| url | https://doi.org/10.1186/s12893-022-01469-3 |
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