Microvascular decompression for trigeminal neuralgia: update.

Purpose Of Review: A recent Cochrane systematic review of surgical interventions for trigeminal neuralgia found not a single trial of what is becoming the most popular surgical intervention, namely microvascular decompression (MVD). With an increasing number of anticonvulsant drugs it is likely that patients may not be offered a surgical option for management of their trigeminal neuralgia for many years.

Recent Findings: Current studies repeat much of what is already in the literature but there is an increasing appreciation of the value of preoperative imaging and the need to be more precise with the diagnosis.

Radiofrequency thermocoagulation for trigeminal neuralgia without intra-operative patient waking.

Objective: It is proposed that radiofrequency thermocoagulation (RFT) under general anaesthesia without waking the patient intra-operatively, which is usually performed to confirm lesion location, will reduce the peri-operative discomfort and anxiety suffered by patients.

Methods: A retrospective review of all procedures, identified through standard hospital audit codes and performed by a single surgeon from 2000 to 2007. Postal questionnaires were sent to all eligible patients.

Clinicopathological review of patients with and without multiple sclerosis treated by partial sensory rhizotomy for medically refractory trigeminal neuralgia: a 12-year retrospective study.

Background: Trigeminal nerve root entry zone demyelination has been implicated as a cause of trigeminal neuralgia (TN) in multiple sclerosis (MS) and patients with nerve root vascular compression. We have examined the relationship between pathology and treatment outcome in patients with and without MS, treated for intractable TN by partial sensory rhizotomy (PSR).

Methods: We reviewed the operative records, electron microscopic biopsy findings and post-operative satisfaction and pain scores of 23 MS and 47 non-MS patients who underwent PSR between 1992 and 2004.

Preliminary evaluation of a novel intraparenchymal capacitive intracranial pressure monitor.

Object: Intracranial pressure (ICP) monitors are currently based on fluid-filled, strain gauge, or fiberoptic technology. Capacitive sensors have minimal zero drift and energy requirements, allowing long-term implantation and telemetric interrogation; their application to neurosurgery has only occasionally been reported. The aim of this study was to undertake a preliminary in vitro and in vivo evaluation of a capacitive telemetric implantable ICP monitor.

Neuralgia of the glossopharyngeal and vagal nerves: long-term outcome following surgical treatment and literature review.

This study describes our experience in the surgical treatment of neuralgia of the glossopharyngeal and vagal nerves. Over the last 19 years, 21 patients underwent surgery. Their case notes were reviewed to obtain demographic information, clinical presentation, surgical findings and early results.