Treatment of Classical Trigeminal Neuralgias – Our Experience at the Sree Chitra Tirunal Institute for Medical Sciences and Technology

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Trigeminal Nerve is the fifth of the cranial nerves capturing sensations over face and helping us chew the food that we eat. Trigeminal Neuralgia is a condition where an aberrant neuronal activity in the nerve leads to pain over the face. This pain comes in shock-like manner lasting a minute or more in a recurrent fashion. Also called “Suicide Disease” the pain drives the sufferer to contemplate ending one’s life. Classical Trigeminal Neuralgia is due to an artery compressing the nerve. The treatment of this condition is initially using medicines which often gives relief for some time. As the frequency and intensity of the pain increases despite multiple medications. Each in increasing doses, other treatment options are contemplated. The definitive treatment of Trigeminal Neuralgia is by separating the offending artery from the nerve and positioning a piece of Teflon between the two, a. procedure called. as Microvascular Decompression (MVD). The other treatment options of Trigeminal Neuralgia includes damaging the Trigeminal Nerve partially so that pain sensation is not transmitted. This list includes – Radiofrequency Thermal Rhizotomy (RFTR) Balloon Rhizotomy and Glycerol Rhizotomy. Radiosurgery is a form of focused radiation that can be used for partially damaging the nerve using radiation This presentation details the experience of Sree Chitra Tirunal Institute for Medical Sciences and Technology in attempting to provide relief to patients with Trigeminal Neuralgia with Micro Vascular Decompression (MVD), Radiofrequency Thermal Rhizotomy (RFTR) and Balloon Compression Rhizotomy (BCR) in the last few years Acknowledgement : Easwer HV1, Krishnakumar K, George C.Vilanilam, Jayanand B Sudhir, Prakash Nair, Ganesh Divakar, Gowtham M, Subin Sukesan2 [1 Department of Neurosurgery, SCTIMST, Trivandrum, 2 Department of Cardiac Anesthesia]