1. Can fifth nerve mapping guide rhizotomy for recurrent trigeminal neuralgia? Case report
- Author
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Tola, S., Morone, F., Carrai, R., Montemurro, V.M., Bonaudo, C., Baldanzi, F., Grippo, A., and Della Puppa, A.
- Abstract
Microvascular decompression (MVD) is usually considered the first-line treatment for trigeminal neuralgia (TN) when medical treatments fail. Recurrence is rare and best treatment option is controversial. MVD was proposed as a feasible and effective technique for recurrent TN by many authors. Nevertheless, in a substantial number of cases, not any impingement or deterioration are found intraoperatively and partial selective rhizotomy is then advised. The rhizotomy site is mostly guided by anatomical landmarks, but variations due to scarring and adhesions are common pitfalls in these second surgeries. Intraoperative monitoring is infrequently used during MVD for trigeminal neuralgia. We describe the use of nerve mapping in a case of recurrence, revealing an unexpected rootlet distribution and thus safely guiding partial rhizotomy.
- Published
- 2022
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