Trigeminal Neuralgia (TN) -  Online Support Group

We are patients living with Trigeminal Neuralgia, here for your support.

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MVD's

For members who either have had, are having or considering having an MVD! Somewhere where those having had MVD's can share their experiences with those who are considering getting this done.

Location: subject-specific group
Members: 343
Latest Activity: on Thursday

Overview

Microvascular Decompression (MVD) is a surgical procedure that relieves abnormal compression of a cranial nerve. It is performed to treat trigeminal neuralgia, vagoglossopharyngeal neuralgia, and hemifacial spasm. These conditions are often caused by an artery or vein compressing the nerve root as it leaves the brainstem. When compressed, normal nerve impulses can recruit nearby nerve fibers and send faulty messages. Medications often provide relief to patients with these conditions, but when medications become ineffective or cause serious side effects, one treatment option is MVD.
What is MVD?

MVD is a surgical procedure to relieve the symptoms (pain, muscle twitching) caused by compression of a nerve by an artery or vein. MVD involves surgically opening the skull (craniotomy) and exposing the nerve at the base of the brainstem to insert a tiny sponge between the compressing vessel and the nerve. This sponge isolates the nerve from the pulsating effect and pressure of the blood vessel.

Trigeminal neuralgia is an irritation of the fifth cranial nerve causing severe pain that usually affects one side of the face, normally in the forehead, cheek, jaw, or teeth (Fig. 1). To treat trigeminal neuralgia, a sponge is placed between the trigeminal nerve and the superior cerebellar artery or a branch of the petrosal vein. By removing the compression, the painful symptoms are relieved.
Who is a candidate for MVD?

You may be a candidate for MVD if you have:

* trigeminal neuralgia that is not well controlled with medication and you desire minimal to no facial numbness that may be associated with other treatments such as percutaneous stereotactic radiofrequency rhizotomy (PSR) or glycerol injection
* facial pain isolated in the ophthalmic division or in all three trigeminal divisions
* facial pain recurrence after a previous percutaneous or radiosurgery procedure

Because MVD involves the use of general anesthesia and brain surgery, patients with other medical conditions or who are in poor health may not be candidates. MVD is not successful in treating facial pain caused by multiple sclerosis. Because of the low risk of hearing loss, MVD may not be suitable for patients who have hearing loss in the other ear.

 

MVD Surgical Risks:

 - Surgical Wound Infection with Lasting Pain, including menengitis.

 - Cerebral Spinal Fluid Leaks

 - Anesthesia Dolorosa -- burning pain underlying facial tactile numbness

- Parasthesia -- an itchy, crawly sensation combined with surface numbness

 - Facial Numbness -- loss of sensation without other sensory effects

 - Partial Facial Paralysis

 · Loss of Hearing (rare, and only with MVD)

 · Loss of the Tearing Reflex of the Eye, with a Risk of Ulceration to the Cornea (also MVD)

 · Surgical Adhesions and Arachnoiditis

 · Central Nervous System Fluid Leak (rare, and only with MVD)

 · Differentiation Pain (caused by surgical interruption of connections between peripheral nerve endings and the central nervous system).

Imagery of MVD:

The following YouTube link provides an unusually clear and well explained description of what is done in a complex MVD for Geniculate Neuralgia and face pain.  Though graphic in detail, it offers one of the better descriptions for what actually occurs in MVD, and how small a place this area near the brain stem actually is, to work. [R.A.L.]

See http://www.youtube.com/watch?v=s7fUqg2aEkc

Discussion Forum

Severe pain in skull 9 months after MVD-please help

Started by jsteph. Last reply by jsteph Dec 6. 10 Replies

I had my MVD in March for right TN.  As the weather changes I've been experiencing an increase in TN pain in the bridge of my nose and behind my right eye.  I can understand that, but last week…Continue

Diary of my MVD Story

Started by tinah276. Last reply by wheels4legs Dec 5. 16 Replies

After a lot of research and prayer, I underwent MVD surgery on April 24.  It has been glorious to live pain free and medication free.  One thing I noticed though as I did my research, was the…Continue

Ten weeks out and just draggggging

Started by Lee. Last reply by freeSpiritDanielle Nov 26. 15 Replies

I'm ten weeks out my second MVD (bilateral TN). I thought I would be stronger by now but am just dragging through each day. Anyone have issues coping post surgery? Any advice? Thanks

Has anyone else had hearing loss after MVD? How long of a recovery time?

Started by freeSpiritDanielle. Last reply by freeSpiritDanielle Nov 10. 7 Replies

I had MVD on 10/27/14, so less than 2 weeks ago. I spent 3 days in the hospital. My neurosurgeon took me off of all meds (including Lyrica, which I had been on 450mg for 3 months). It was an…Continue

Tags: ATN, MVD, Neuralgia, Geniculate

Comment Wall

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Comment by Lou on October 28, 2014 at 5:44pm
2 months out and I was feeling well enough to cut back to one pain pill if any a day. I had pressure in a rear molar. So... I did an insane thing. Not having put my appliance in on the left side of my mouth I tried to put it in. It was a removable bridge made to replace to rear molars. I do not have any issues on the left side. The bridge was so tight I could not remove it and left it in and went out for 4 hours. I returned home and managed to rock it out. Needless to say I am in so much pain on the right side now. Where it was quiet there is now storm. I only mention this so no one else attempts to do this while healing. My teeth had shifted over the last six weeks and the removable bridge no longer fits or ever will, and my nerves are screaming WTF!! I only have myself to blame. My lip burns and my teeth feel so pressured. So if you think you can. Don't!!!!! Wishing everyone free of pain.
Comment by kathiegil on August 13, 2014 at 7:04pm
I came up to johns Hopkins and had the mvd yesterday. I am feeling surprising well and will be discharged tomorrow . We stay up here for 2 weeks to get stitches out then fly back home to fla.
Comment by angie r on August 13, 2014 at 9:22am

I had my MVD on 6th August and the operation went well, an artery and 2 veins were touching my nerve, the surgeon Mr Quigley in RVH in Belfast, wrapped the nerve in Teflon. I got home from hospital on 11th August.  Post operative care was excellent with no major problems except having to deal with side effects of reducing my Lyrics which is making me very lightheaded, dizzy and unsteady. My TN  pain was masked by my medication or I was in remission so I need to wait until my medications are reduced to see if the operation was successful. I am just taking lots of rest and I need assistance to move about. All your tips are helping thanks everyone.

Comment by Bonnie on August 11, 2014 at 8:49pm

Tiffanie, was your MVD successful after your 3 yr wait? 

Comment by Bonnie on August 11, 2014 at 8:42pm

Thanks for the feedback everyone!  Everything moves slower in Canada.  I had a tentitive diagosis at the end of March and it took 6 wks to see a Neurogist to confirm. Two months later I ws able to see a local neurosurgeon who has a wait list of 1 - 1 1/2 yrs. Then back to my neurogist to get a referral to another surgeon, Dr Honey, from UBC in Vancouver.  I believe Dr. Honey is the surgeon I will use based on their website, but they are closed the month of August so I haven't been able to get a date for my initial appt yet. The surgical wait list for Vancouver will probably be longer. I expect a 2-3 year wait between the initial diagnosis and the actual surgery,  I'm not in any pain now with the Tegretol so I wasn't minding the wait, except for my nervousness in just thinking about this. I did read Striking Back, by the way, between Dr visits.

Comment by tiffanie on August 11, 2014 at 8:07pm
I was told by my local Neuro and 3 other Neuros I consulted with, that I should take meds as long as I can handle it. And use MVD as a last resort. That is so outdated! The longer the nerve is compressed, the more damage is being done.
I ended up waiting 3 years, for a total of 5 from first symptoms. I wish that I would have gone in right away!
Comment by KATTHOMPSON4 on August 11, 2014 at 6:54pm
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Comment by mybell on August 11, 2014 at 6:39pm

I was diagnosed 4 days after my initial symptoms of TN1 and had my MVD by Dr. Casey 9 months later. I'm now 10 months out from surgery and pain free and med free. I made the decision to have an MVD 3 months after my diagnosis but then spend several months finding the right surgeon. I booked my MVD last July and then waited a few months to get my ducks in order and had the surgery last October. Best decision for me!

Comment by Mace on August 11, 2014 at 5:52pm

Bonnie i would not wait if your going that route. from my first dr visit to surgery was about 8 months, that was taking the earliest appointments for every visit to specialists. 

Comment by Anna on August 11, 2014 at 5:51pm
I've had 3 MVD's and gamma knife. The last 2 MVD's were in June and neurolysysis was performed on the 3rd one. It seems to be almost completely successful :) I'm off one of my meds and cut back significantly on tegretol. I'm so excited!!
 
 
 

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