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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: 327
Latest Activity: 20 hours ago

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

Scheduling MVD with Dr Casey

Started by Kathy. Last reply by Renee 20 hours ago. 19 Replies

I saw Dr Casey on Fri. He was awesome!! He spent an hour and a half with us. He thinks I have compressions on my trigeminal, vestibulocochlear and facial nerves on the left. I have TN type 2 on the…Continue

When to say MVD was unsuccessful

Started by teacher58. Last reply by teacher58 Jul 15. 9 Replies

I had my MVD 7 months ago on Dec. 5, 2013. It took until April 1 to totally wean off all meds (800 mg. Tegretol & 30 mg. Baclofen). Since then, I have had intermittent, mostly mild, pain. It…Continue

What our hair looks like post MVD

Started by ihold. Last reply by mybell Jul 3. 28 Replies

I know this is the silly and vain side of us that comes out when thinking about MVD. Hey, I thought about it. Even though I was worried about what was going to happen when they did brain surgery, I…Continue

Can anyone give advice on the best sleeping position post mvd

Started by angie r. Last reply by angie r Jun 25. 8 Replies

I am preparing for my mvd surgery hopefully in August I am just waiting on the actual date. To ensure a good night's sleep when I get home post operatively what is the best solution? Is it better to…Continue

Comment Wall

Comment

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Comment by kathiegil on July 14, 2014 at 8:32pm
Thank you Tiffani,Red and Maur. Definitely some insightful questions to ask.
Comment by tiffanie on July 14, 2014 at 3:33pm
Red and maur have excellent suggestions!
Comment by Maur on July 13, 2014 at 11:23pm

Kathie, ask your operating neurosurgeon about his/her successes with this type of operation, but also ask about his failures. Performing the same op regularly is an important aspect because surgeons gain valuable experience, but you will want to know how many of these are successful. If any unsuccessful operations are admitted to, ask what happened and how those patients are doing now, and if you like, ask if a meeting with any patients can be arranged so you can talk to them. Also I advise you to put your operating neuro's name out here, and if they have done a number of MVDs there are sure to be patients on here who can let you know of the success or otherwise of their ops. Your surgeon should have a good reputation for successful MVDs, and you ought to be looking for that, look for testimonials from past patients. Choosing your neurosurgeon carefully is probably the most important thing that you as a patient can do for yourself. All the very best. 


Moderator
Comment by Richard A. "Red" Lawhern on July 13, 2014 at 8:39pm

Kathie,

1.  Do you do follow-up surveys of your patient outcomes, and if so for how long? 

2.  What percentage of your patients are pain free initially or within six months after MVD for conditions similar to my presentation?

3.  What are the primary surgical side effects you will monitor for?
4.  What proportion of your patients have later presented with Anesthesia Dolorosa?  How many with CNS fluid leaks?

5.  What steps do you take to minimize manipulation of the nerve during the procedure?

6.  Do you do endoscopic examination during the discovery phase of the procedure?

Not all surgeons will answer all of these questions.  But the more of them your consult addresses, the greater your confidence can be that the surgeon is actively seeking to employ best practices.

Regards, Red

Comment by kathiegil on July 13, 2014 at 6:53pm
I am flying up to john Hopkins for a consult about a mvd this week. Any questions I should be asking. I know this doctor does them often.
Comment by Siminative on July 5, 2014 at 2:03pm

Thank you Red.  There are a lot of meds mentioned here that I have not tried yet.  I think that I will ask my neurologist about them before I try surgery.  As always you were a big help.

Nancy

Moderator
Comment by Richard A. "Red" Lawhern on July 5, 2014 at 1:22pm

A number of people here and elsewhere with whom I've talked, have had MVD for atypical TN.  Dr. Peter Janetta used to say that he would do the operation with anyone who had ever had the sharp electric shock pain volleys of typical TN, even if their present patterns of pain were dominated by the ache and throbbing of atypical TN.  Successful outcomes are not as frequent in atypical TN. One paper I've seen reported major improvement or cessation of pain in a third to half of a group of hundreds of ATN patients who had the operation.  Dr. Ken Casey also reports that in ATN patients followed for a period of years, the reports of overall improved life style values were nearly the same in the two groups.

There is a two-hour video clip of Dr Casey with a group of TN patients, from the center column in the main page here at LWTN.  The presentation is focused on treatment of ATN and it may be worth your time to view it.
Go in Peace and Power

Red

Comment by Siminative on July 5, 2014 at 1:13pm

Has anyone has an MVD for atypical TN?  AND has anyone had an MVD at Kaiser in Los Angeles?  I'm thinking of having one and would like to know if there's any point to it.  I'm also really afraid of the risks.  

thanks

Nancy

Comment by vevi on June 23, 2014 at 2:08am
Hello everybody!! It has been one year after my surgery, no more pain pills, no more pain but I still have some numbness. It's not as bad as the beginning, I guess I need to learn how to leave with it.
Comment by kathiegil on June 22, 2014 at 7:07pm
My neurologist told me to go to miami hospital to see the neurosurgeon. Anyone have a mvd there?
 
 
 

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