Abstract
Background Trigeminal neuralgia is one of the most common causes of facial pain with the highest
incidence in individuals > 60 years old. Despite the proven efficacy and safety of
microvascular decompression (MVD) for the treatment of trigeminal neuralgia, some
physicians are reluctant to perform the procedure in elderly patients because of potential
complications.
Material and Methods In the present study, we analyze the outcome of MVDs performed over a 10-year period
in elderly patients and compare the results with those obtained in younger patients.
A total of 32% of the patients were ≥ 65 years of age at the time of diagnosis. All
of the patients were treated via a small retrosigmoidal approach because of reluctance
for medical treatment. Overall, 87% of the patients exhibited microvascular compression
of the fifth nerve in the root entry zone and were treated using MVD; the remainder
of the patients were treated using a trigeminal root compression technique when a
vessel was not compressing the fifth nerve.
Results After the procedure, 93% reported complete relief of pain with a recurrence rate
of 10.8% over a mean time of 43 months. A total of 10% of the patients experienced
severe complications related to the operation with no mortality.
Conclusion MVD continues to be the procedure of choice for the treatment of trigeminal neuralgia
in patients reluctant to medical treatment, including elderly patients because age
is not a contraindication.
Keywords
trigeminal neuralgia - microvascular decompression - elderly
