Micro vascular Decompression:
This is a surgical procedure performed for patients suffering from trigeminal neuralgia, hemifacial spasms and glossopharyngeal neuralgia which are thought to be caused by the arteries compressing the cranial nerves at the root entry zone (REZ) as the come out of the brainstem.
It is also known as tic douloureux, where the the trigeminal nerve is compressed by the artery. These arterial pulsations produce very severe, pulsatile, stabbing, episodic facial pain in one or more branches of trigeminal nerve.
- V1: branch to the fore head
- V2: branch to the upper lip
- V3: branch to the jaw
In such patients, some other artery compresses the facial nerve (7th cranial nerve) and results into abnormal and uncontrollable facial spasms of the same side of the face.
In this some more different artery compresses the 9th Cranial nerve( glossopharyngeal nerve) and result into a stabbing pain in the throat radiating from the ear.
There are multiple treatment options available for these conditions.
- Drug treatment: Trigeminal neuralgia can be treated conservatively using the drug carbemezapine, which may provide relief to many patients. Hemi facial spasms can be treated using Botox injections locally. Glossopharyngeal neuralgia, nerve blocks may provide some relief.
- Focal radiations: It is also one of the option for treating such patients, but radiation damage the nerve as well and produce more symptoms
- Microvascular decompression: It is a micro surgical option in which we first separate the artery from the nerve and then we put Teflon pledgets in between them, so that the arterial pulsations are not transmitted to the nerve and the symptoms improve.