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Trigeminal neuralgia management after microvascular decompression surgery: two case reports

Journal of Dental Anesthesia and Pain Medicine 2020년 20권 6호 p.403 ~ 408
Hwang Victor, Gomez-Marroquin Erick, Enciso Reyes, Padilla Mariela,
소속 상세정보
 ( Hwang Victor ) - University of Southern California Herman Ostrow School of Dentistry
 ( Gomez-Marroquin Erick ) - University of Southern California Herman Ostrow School of Dentistry
 ( Enciso Reyes ) - University of Southern California Herman Ostrow School of Dentistry
 ( Padilla Mariela ) - University of Southern California Herman Ostrow School of Dentistry

Abstract


Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

키워드

Carbamazepine; Case Reports; Gabapentin; Microvascular Decompression Surgery; Trigeminal Neuralgia

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