Tag: Trigeminal nerve

Microvascular Decompression Surgery

Posted on | by Dr. Jaydev Panchwagh | Leave a Comment on Microvascular Decompression Surgery

Microvascular Decompression Surgery or MVD surgery is a brain operation, commonly done to relieve nerve compression of the fifth (Trigeminal nerve) and seventh (Facial Nerve) cranial nerves. Occasionally the ninth (Glossopharyngeal nerve nerve is also decompressed by itself or in conjunction with the Trigeminal nerve. Cranial Nerves are nerves that arise in the brain. They are twelve in number.

All about MicroVascular Decompression:

 

What is MVD surgery?

There are twelve nerves that arise from the brain, on each side. Of these, the fifth (Trigeminal nerve), seventh-eighth complex(Facial-Vestibulocochlear) and ninth(glossopharyngeal) nerves are prone to compression leading to hyperactivity disorders that need treatment.

What is the fifth nerve called?

The fifth cranial nerve is the Trigeminal Nerve. The Trigeminal nerve supplies the sensation to the face. It has three divisions : V1,V2 and V3. these supply specific areas of the face on each side.

What is the seventh-eighth nerve called?

The seventh-eighth cranial nerve complex is the Facial nerve-Vestibulocochlear nerve complex. The facial nerve supplies the facial muscles. The eighth nerve is the nerve of hearing and balance. This is the reason why in Hemifacial spasm, occasionally, either tinnitus or a clicking sound may be heard.

What is the ninth nerve called?

The ninth nerve is the Glossopharyngeal Nerve. It supplies sensation to base of tongue, tonsillar pillars and throat. There are other functions too, but this is the function most affected in glossopharyngeal neuralgia and causes pain while swallowing.

What is Microvascular Decompression surgery?

It is an operation done at the level of the brainstem, where the involved nerve exits/enters the brainstem. The blood vessel compressing the nerve is moved away from the nerve(decompressed) using a microscope/ endoscope or both. This is performed to treat Trigeminal neuralgia, Hemifacial spasm or glossopharyngeal neuralgia.

Is it possible to see a video of MVD surgery?

Certainly. Dr. Jaydev Panchwagh, chief Neurosurgeon and Director at the MVD Centre shows us how it is done. here:

If you are interested in knowing more about a video discussing diagnosis, symptoms, MRI and treatment, please click here.

Can I get a comprehensive idea about Trigeminal neuralgia?

Yes, you can read all about it on this page.

What is Trigeminal neuralgia?

Posted on | by Dr. Jaydev Panchwagh | Leave a Comment on What is Trigeminal neuralgia?

What is Trigeminal Neuralgia?

Trigeminal neuralgia is a chronic facial pain caused by a hyperactivity disorder of the Trigeminal nerve. In simple words, it is a symptom of Trigeminal nerve compression. This compression could be caused by a blood vessel or by a tumor, among many other causes. TN  pain is severe and is generally treated with medicines, initially.

What is the trigeminal nerve?

Trigeminal nerve is the fifth nerve which is given off from the brain. It is a cranial nerve. This is a sensory as well as motor nerve. It means that the nerve supplies sensation to the face and the motor component supplies muscles of chewing.

What is the commonest presentation of trigeminal neuralgia?

Commonly TN pain begins after some form of dental treatment, either an extraction or root canal work. However, the dental work actually is only a trigger, not the cause. Other triggers for the trigeminal neuralgia pain are brushing, eating, talking, shaving, touching etc.

Can Trigeminal neuralgia be associated with ear pain?

Yes. TN itself can cause ear pain; but it may also be associated with Glossopharyngeal neuralgia which can also be the cause of ear pain.

How is the pain of Trigeminal neuralgia?

The patient has severe electric shock like or lightning like pain in the eye, cheek, gums or jaws. Mostly, this disorder is diagnosed late. Thus the patient suffers for many years before they are told their diagnosis. It is frequently mistaken for migraine, dental pain or ear pain. MRI is performed to support the clinical diagnosis.

Can MVD be done after RFLG?

Yes, but a primary MVD always gives better success. Radio Frequency Lesioning or ablation of the trigeminal nerve is a destructive procedure. MVD surgery is a nerve-preserving procedure.

Who performs the MVD surgery?

MicroVascular Decompression (MVD) surgery is a brain surgery and is performed by a neurosurgeon. An experienced neurosurgeon gives the best results, better success rates and lower chances of risks.

Can we get any patient testimonials or their experiences?

Sure. Please click here to read and watch videos of patient experiences. All these patients have been operated by our team, at the MVD Centre. You can click here to read more Frequently Asked Questions on Trigeminal neuralgia and MVD surgery. You can visit the home page of this website on trigeminal neuralgia treatment by clicking here.

Who runs the MVD Centre?

The MVD centre is in Pune. The Director is Dr Jaydev Panchwagh, who has an experience of more than 30 years in the field of neurosurgery. His passion in the specialty is MVD surgery.

 

Severe Trigeminal Neuralgia caused by Epidermoid tumour

Posted on | by Dr. Jaydev Panchwagh | 19 Comments on Severe Trigeminal Neuralgia caused by Epidermoid tumour
CP angle Epidermoid Tumor
MRI of C-P Angle Epidermoid Tumor

Severe Trigeminal Neuralgia can occasionally be caused by tumors in the cerebello-pontine region, notably, Epidermoid tumors, Schwannomas and rarely others like meningioma etc.

Severe TN caused by C-P angle Epidermoid tumor

This is the story of a patient named Mr. Gopal Shinde, a young man from rural Maharashtra who suffered from very severe pain in the cheek and forehead. His TN pain was so severe that he could neither eat nor talk, nor open his mouth.

An MRI advised by us revealed a cerebello-pontine (C-P) angle tumor which was likely to be an epidermoid. Unfortunately, a nation-wide lockdown was imposed a few days after his diagnosis, and he had to return to his village.

Eventually, in spite of the Covid-19 situation, he came back to us for excision of the epidermoid, because the pain was unbearable. This was successfully removed in October 2020. His severe Trigeminal neuralgia pain disappeared immediately after surgery and he could begin eating, talking and smiling normally.

 

Dr. Jaydev Panchwagh operated on him and he was cured of his TN pain, with the excision of the Epidermoid tumor and with the freeing of the Trigeminal nerve.