IDIOPATHIC TRIGEMINAL NEURALGIA: CLINICAL PRESENTATIONS AND OPERATIVE FINDINGS ON MICROVASCULAR DECOMPRESSION

Abstract

Objective: To analyze the clinical presentations of idiopathic trigeminal neuralgia and its operative findings on microvascular decompression.

Material and Methods: This descriptive case series study was conducted in the Department of Neurosurgery, PGMI, Govt. Lady Reading Hospital, Peshawar from July, 2003 to November, 2007. A total of 110 consecutive patients of idiopathic trigeminal neuralgia undergoing microvascular decompression in the Department of Neurosurgery, Lady Reading Hospital were included in the study. Clinical presentations and operative findings were recorded and analyzed. All cases of secondary trigeminal neuralgia were excluded with the help of MRI brain.

Results: Ratio of Male: female was 2:3. Age ranged from 28-80 years, mean age being 57 years. Right side was affected in 60% cases. Maxillary and mandibular divisions in combination were involved in majority of cases. Pain-free period varied from few hours to years. The common triggering stimuli were chewing and touching. A trigger point was found in (77%) cases. Superior cerebellar artery was the cause of compression in 90% of cases. In 90% of cases compression was on the root entry zone. The nerve compression was found on superomedial aspect in 66(60%) of cases.

Conclusion: Almost all cases of idiopathic trigeminal neuralgia are caused by a vascular compression of the trigeminal nerve, superior cerebellar artery being the commonest cause 90%.