Management of Primary Bilateral Trigeminal Neuralgia with Microvascular Decompression: 13-Case Series.

Abstract

Bilateral trigeminal neuralgia is a relatively rare disease. Microvascular decompression (MVD) is a safe and effective treatment for unilateral trigeminal neuralgia; however, its utility in bilateral trigeminal neuralgia is unclear. Here, we report our experience with MVD in 13 cases of primary bilateral trigeminal neuralgia. We retrospectively analyzed 13 cases of bilateral trigeminal neuralgia that were treated with MVD between January 2013 and January 2015. Surgical outcomes and complications were explored in each case. Postoperatively, 11 patients had excellent outcomes and 2 patients had good outcomes on the operative side. Three patients also reported the amelioration of contralateral symptoms after MVD. Of 10 cases indicating no contralateral improvement, 1 refused to undergo a second MVD procedure on the opposite side and 9 underwent a second MVD procedure and experienced symptom relief. The superior cerebellar artery was the most common offending vessel. There were no severe MVD-related complications. Vascular compression plays a causative role in bilateral and unilateral trigeminal neuralgia. MVD appears to be a safe and effective treatment option in patients who are refractory to pharmacotherapy.