From Agony to Relief: How Microvascular Decompression Surgery Ended Severe Nerve Pain

A young lady, Renu Somani from Udaipur, Rajasthan, was experiencing an agonizing facial pain. Initially, she attributed it to a troublesome tooth and underwent tooth extraction in search of relief. However, the pain persisted and became more severe and tormenting like electric shocks.

Fortunately, Renu was advised to visit Shalby Multispecialty Hospital, SG and seek medical guidance for her problem. Here, she met Dr. Harshil Shah, Senior Neuro Surgeon who diagnosed her with Trigeminal Neuralgia, a medical condition known for causing unbearable pain on one side of the face. Dr. Harshil Shah provided her with a surgical solution- Microvascular Decompression (MVD) surgery to help her end the pain. With courage and trust, she underwent the procedure, and within days, the unbearable pain receded. On the third day post-surgery, Renu could eat and speak —a testament to the transformative power of medical intervention.

This blog attempts to explore the various nuances of the ground-breaking MVD surgery and how it is a beacon of hope for all those battling facial pain.

Let us first understand what is MVD:

What is Microvascular Decompression?

Microvascular decompression is a surgery used to help people with severe facial pain or spasms that aren’t relieved by medicines. It’s an option for conditions like trigeminal neuralgia, glossopharyngeal neuralgia, or hemifacial spasm. These problems can happen when a blood vessel squeezes a cranial nerve. Each time the blood pulses through the vessel, it annoys the nerve and causes sharp facial pain and muscle twitches.

Trigeminal neuralgia is a condition where intense pain affects one side of the face, often in areas like the forehead, cheek, jaw, or teeth. To treat this, Microvascular Decompression (MVD) is performed. During MVD, a small sponge is placed between the trigeminal nerve and a nearby blood vessel (either the superior cerebellar artery or a branch of the petrosal vein). This sponge acts as a buffer, relieving the nerve from pressure and reducing the painful symptoms. The surgery involves opening the skull to access the nerve at the base of the brainstem.

Who are Eligible for Microvascular Decompression Surgery?

• Patients with Classic Trigeminal Neuralgia: Patients with intense, jolting facial pain triggered by activities like touching the face, eating, or talking.
• Failed Medications: MVD surgery is considered when medications (such as anticonvulsants) fail to provide adequate pain relief or cause intolerable side effects.
• Patients with No Prior Brain Surgery: Individuals who have not previously undergone brain surgery are eligible for MVD surgery.
• Candidates in Good Health: Healthy individuals who can tolerate surgery and general anaesthesia are eligible for Microvascular Decompression (MVD). However, those with significant medical conditions or poor overall health may not be suitable candidates due to the brain surgery involved.
• Willingness to Undergo Surgery: Patients must be willing to undergo a craniotomy (skull opening) to access the nerve.

However, it is essential to consult with a neurosurgeon to determine individual eligibility and discuss potential risks and benefits of the procedure.

Recovery After MVD Surgery:

Microvascular Decompression (MVD) is a highly effective treatment for trigeminal neuralgia, boasting a success rate of 95%. Unlike other procedures like percutaneous stereotactic rhizotomy (PSR), MVD offers a significant advantage: it minimizes or eliminates facial numbness.

After MVD surgery, most patients experience immediate pain relief, and the long-term success rate is impressive, with up to 75% of patients remaining pain-free for five years or more post-surgery. Additionally, the recovery time is relatively short, allowing many patients to leave the hospital within a couple of days.

Dr. Harshil Shah, a Senior Neuro Surgeon, Shalby Hospital, SG, emphasizes the importance of timely treatment for trigeminal neuralgia. He informed,”Patients often suffer without understanding the root cause, leading to mental and physical strain. At Shalby, we have a state-of-the-art team and infrastructure dedicated to treating these patients. Trigeminal neuralgia should not be underestimated and seeking treatment promptly can lead to a healthier, happier life with a perpetual smile.”