MRI Specialist Migraine Treatment Centers
When a nerve in the skull tightens abnormally it causes severe facial pain called trigeminal neuralgia (TN). The tightening of this nerve also causes involuntary twitching/ contraction of muscles on one side of the face. This one-sided muscle twitching on the face is called hemifacial spasm. The current treatment for hemifacial spasm (HFS) is a surgical procedure called microvascular decompression. This procedure still involves a high risk because of the area where the surgery takes place. To refine this procedure thousands of MVD cases were investigated.
The study was conducted at a specific department. The department received 3000 consecutive cases of MVD. 2601 of these cases were of people who specifically experienced TN and HFS. The 2601 patients were included in the study. The surgical findings and the results of the operation were investigated and compared between the two groups. Authors also investigated how each surgical procedure was carried out.
88.3% of patients were pain or spasm free after the MVD operation. The symptoms improved slightly in 7.2 % of patients. 4.5% of patients had no improvement in symptoms. Most patients with poor results had a second MVD after. 98.7% of patients who had a second operation showed improvement. The surgeries failed to give positive results mainly because the main vein and artery that had to be operated on for TN and HFS respectively, were missed. The main artery involved in HFS is located far in the center of the cranium.
In conclusion, the authors found that when the target area in the cranium is found quickly the MVD is successful. To improve the procedure the opening of the skull for surgery should be done close to the veins in the skull called sigmoid sinus. All of the nerve routes in the skull need to be examined. Veins and arterioles also need to be looked at. For TN patients all the vessels contacting the target nerve need to be separated. For HFS the operation should be central to a specific site known as the pontomedullary sulcus.
View the original migraine treatment study at this link: A clinical analysis on microvascular decompression surgery in a series of 3000 cases