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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neuromuscular Disorders and Peripheral Neuropathies
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1496656
This article is part of the Research Topic Advancements in Surgical Strategies and Technologies for Cranial Nerve Disorders View all 7 articles

Immediate Consecutive Microvascular Decompression for Bilateral Classical Trigeminal Neuralgia

Provisionally accepted
Mauro Alberto Segura-Lozano Mauro Alberto Segura-Lozano Mario Alexis Del Real-Gallegos Mario Alexis Del Real-Gallegos Pedro Mendoza-Lemus Pedro Mendoza-Lemus Octavio Carranza-Rentería Octavio Carranza-Rentería Yael Rodrigo Torres-Torres Yael Rodrigo Torres-Torres Alejandro González-Silva Alejandro González-Silva Arturo Santoyo-Pantoja Arturo Santoyo-Pantoja Aarón Giovanni Munguía-Rodríguez Aarón Giovanni Munguía-Rodríguez *
  • Hospital Ángeles Morelia, Michoacán, Mexico

The final, formatted version of the article will be published soon.

    Background: Classical trigeminal neuralgia (TN) is characterized by sudden, severe facial pain, typically resulting from a neurovascular conflict affecting the trigeminal nerve. In rare cases, both nerves are affected simultaneously causing bilateral TN (BTN), increasing the complexity of the treatment. Microvascular decompression (MVD) is a well-established treatment for TN; however, the experience with immediate consecutive bilateral MVD procedures is limited and requires further evaluation.Objective: To evaluate the safety and efficacy of immediate consecutive bilateral MVD in patients with severe BTN compared to non-consecutive bilateral MVD procedures.A retrospective analysis was conducted on 15 patients with BTN who underwent bilateral MVD. The data on clinical presentation, surgical technique, perioperative findings, complications, and follow-up outcomes of three cases of BTN treated with consecutive bilateral MVD surgeries were analyzed and compared to twelve who received separated procedures. Moreover, a detailed presentation of the three cases of consecutive MVD is provided to illustrate clinical decision-making, surgical nuances, and individual outcomes.Results: Both groups achieved significant pain relief (p < 0.001) without notable differences in Barrow Neurological Institute (BNI) pain intensity score (p = 0.305), indicating that both approaches were equally effective. The consecutive MVD group experienced a shorter total surgical duration (p = 0.025), while postoperative complications were comparable (p = 0.077), mostly transient with no major adverse events or mortality. At the last follow-up, the patients remained pain-free without recurrence of TN symptoms.Consecutive bilateral MVD is a safe and effective option, comparable to nonconsecutive procedures for treating BTN. This approach provides a viable alternative for patients with severe bilateral symptoms or when medical constraints limit the possibility of two separate surgeries. Further studies with larger cohorts and extended follow-up periods are needed to support these results.

    Keywords: Bilateral trigeminal neuralgia, Microvascular decompression, Neuropathy, Facial Pain, Neurovascular conflict

    Received: 15 Sep 2024; Accepted: 07 Nov 2024.

    Copyright: © 2024 Segura-Lozano, Del Real-Gallegos, Mendoza-Lemus, Carranza-Rentería, Torres-Torres, González-Silva, Santoyo-Pantoja and Munguía-Rodríguez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Aarón Giovanni Munguía-Rodríguez, Hospital Ángeles Morelia, Michoacán, Mexico

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