Trigeminal neuralgia - microvascular decompression by teflon
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According to the international headache society (IHS), trigeminal neuralgia (TN) is a disorder characterized by recurrent unilateral brief, shock-like pain abrupt in onset and termination, limited to the distribution of one or more divisions of the trigeminal nerve.

Peak incidence is between the ages of 50 and 60 years, more common in women. Patients with TN are best managed by coordinated multidisciplinary approach (medical and surgical management). Early surgery helps the patient to have a better quality of life rather than waiting with the medical therapy alone.

Published in the Journal of Scientific Society, the authors present a case of an old aged male patient with h/o right side facial pain in V1 and V2 distribution, diagnosed with trigeminal neuralgia, and was on prolonged drug therapy for the same with no signs of improvement.

The patient was subjected for Microvascular decompression after confirming the vascular loop compressing the ipsilateral trigeminal nerve. Patient showed improvement with symptom free interval subsequently.

Key takeaways:-

- TN is a purely clinical diagnosis; there is no confirmatory laboratory or imaging study for this disease. However, there are electrophysiologic and imaging studies that may be useful as an adjunct to clinical acumen.

- Trigeminal-evoked potentials and electrophysiologic studies are not widely used but are complementary diagnostic tools.

- MRI and magnetic resonance angiography processed as 3D images have been used to verify vascular compression and other causes for secondary TN.

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