Trigeminal neuralgia, although considered a rare condition, affects around 140,000 people in the United States. If you are one of these individuals, you have been living with the pain and frustration that accompanies this debilitating condition. While there is no cure, relief can be found through microvascular decompression (MVD) surgery for trigeminal neuralgia.
What Is Trigeminal Neuralgia?
You have 12 pairs of cranial nerves that serve different functions throughout your head. Each of these nerves branches out from the base of your skull, serving to provide muscle control and facial sensation to different areas of your face. Trigeminal neuralgia affects the fifth cranial nerve, which is responsible for the sensation in your cheeks, chin, temples and around your eyes. When this nerve is compressed by a nearby blood vessel such as a vein or artery or is damaged in some way, it can misfire and create painful impulses.
Many people experience trigeminal neuralgia as an intensely painful electric shock-like sensation that occurs on one side of the face. It is intermittent and can last from a few seconds to a few minutes. Some people experience it only occasionally while others may have multiple episodes in the course of a day. In the majority of cases, the pain is strong enough to be debilitating.
Microvascular Decompression Surgery for Your Trigeminal Neuralgia
Many people will start out with medications to treat their trigeminal neuralgia but will have limited or no success with it. Others experience unbearable side effects that make medication a poor choice for treatment. At this point, a different treatment needs to be sought to address the symptoms.
If you are in good health, can withstand general anesthesia and your trigeminal neuralgia is caused by nerve compression from a blood vessel, you may be a great candidate for microvascular decompression surgery. To better understand the relationships between your trigeminal nerve and surrounding blood vessels, you will need to have a FIESTA-MRI. This is a special imaging study that allows your surgeon to see individual nerve and vascular structures. Through this MRI, it will be evident if a vein or artery is pressing on your trigeminal nerve. If this is the cause of your symptoms you likely will be referred for microvascular decompression surgery.
Getting Ready for Surgery
Prior to having surgery, your surgeon will require you have bloodwork to check organ function, blood sugar and red blood cell count. Be sure to get this done as soon as possible so as not to delay your surgery date.
Additionally, it’s helpful to arrange for assistance once you’ve arrived back home from surgery. Tasks such as driving, cooking and cleaning tend to be too strenuous for the first few days at home.
On the day of your surgery, you will be admitted to the hospital. You will be taken to a surgical preparation area where you will get ready for your procedure. Be sure to leave jewelry such as necklaces and earrings at home, as you will not be able to wear these during your operation. You will also meet with your surgeon and anesthesiologist at this time. A nurse will place an IV and you will be sedated and taken to the operating room.
In the Operating Room
Once you are fully asleep under anesthesia, your surgeon will begin your surgery. An incision will be made in the skin at the base of your skull. A small portion of bone around the size of an American quarter will be removed to allow your surgeon access to the nerves and blood vessels. Specialized instruments including a surgical microscope will be used to perform the surgery. Once your trigeminal nerve and the offending vein or artery are located, your surgeon will gently move the structures apart and place a Teflon sponge between the two. This tiny sponge will act as a buffer, preventing the blood vessel from causing further irritation to the nerve. Once everything is in place and the nerve is responding properly, your skull will be closed and the skin sutured back into place. You’ll then be moved to the recovery area.
Recovery From MVD
Most patients who have microvascular decompression surgery stay in the hospital between one and two days. Once you get to go home, you will need to get plenty of rest and eat a well-balanced diet. Taking short walks throughout the day will keep your circulatory system healthy and promote healing. Having help during this period is a good idea as you will still be taking pain medication, which can make you woozy.
By the second or third week, you can expect to have more energy. It’s important not to overdo it – your body is still healing from surgery. Increase your activity level incrementally and be sure you are following your doctor’s orders. Many people in low-impact occupations will be able to return to work. If you work in a strenuous or physically-demanding job, you will have to wait longer to return to work. You still need to be mindful of your limitations and not overtax yourself.
You will have follow-up appointments with your surgeon to check your progress. It’s important to attend each of these to ensure that you are healing properly.
You can expect complete and total healing within six months after surgery.
