Trigeminal Neuralgia (TN) -  Online Support Group

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



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: 370
Latest Activity: Apr 18


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.]


Discussion Forum

TN flare a year after MVD?

Started by Lee. Last reply by Dixie Apr 6. 5 Replies

Anyone flare a year or more after MVD? It will be two years in June since my MVD on left side (bilateral - first MVD on right side). I'm flared on left-not as severe as before surgery, but…Continue

Endoscopic MVD - Abstracts

Started by Richard A. "Red" Lawhern. Last reply by Sri Mar 31. 9 Replies

I did some research on behalf of one of our members, and thought I would cross-post here in the MVD group.  The following are abstracts of reports on the effectiveness of MVD done with an…Continue

Tags: outcomes, MVD, endoscope

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

Started by freeSpiritDanielle. Last reply by littlemoth Feb 20. 14 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

Dr William Freidman

Started by Dnlhappel Feb 11. 0 Replies

Has anyone had any experience with Dr William Freidman in Gainesville Florida?

Comment Wall


You need to be a member of MVD's to add comments!

Comment by Delia Osuna-Orozco on July 5, 2015 at 9:20pm
Thanks Gloria...I'm trying to relax...don't know if this is going affect my MVD hope not...
Comment by gloria on July 3, 2015 at 5:09pm
Sorry Delia, positive thoughts our prayers got out to u, u r going to be ok please don't let this worry u, meditate relax urself try not to stress about this.ur going to be fine
Comment by Delia Osuna-Orozco on July 3, 2015 at 3:13pm
Congrats Dixie....I'm 3 years post MVD although I sometimes have tingles I still take meds...but never like before...thank God!!! but now with great sadness like to share with you that I found a lump on my breast :( :'( and I'll be having surgery to remove it to see what it is....I'm so sad been crying alot hope to God that its not positive...don't even want to know how this will effect my TN....sniffff I'm going crazy I have an app. with the oncologist on the 13th to schedule the surgery.....sniffff
Comment by FootprintsInTheSand on June 30, 2015 at 9:29pm
So happy for you Dixie! Happy Birthday!
Comment by gloria on June 30, 2015 at 9:35am
Congrats Dixie
Comment by Dixie on June 30, 2015 at 8:41am
I just want to say, "Hello" to all my special friends out there. I am 2 1/2 yrs post MVD & continue to be pain free & off all meds. On Friday, July 3, I will be 71 yrs old & never thought I could have endured living with TN without the support & knowledge I got from this site. Thanks be to God & to my friends that I have my life back. I wish you all strength.
Comment by tkal on June 12, 2015 at 9:17pm

Thanks Red,

I don't think I explain it correctly.

The shingles actually showed up at the end of May and I am the end phase of the illness. We did agree that we would wait until the illness finished it's cycle before surgery.

Oh, I do have the rash. On my face and in my mouth. The nerve fiber along the jaw. It's a mild rash as far as shingles go but bad enough for people to stay far away. I can already tell which parts I'm going to have scars on. I have the larger blisters and the very tiny blisters you can't see. But also had the scraping to confirm so that I could get enough pain meds to last me through the illness. And you do need them.

From what I read. They can't really decide if you have post herpetic neuralgia until months after the rash goes away. This is the only time I've only had shingles so there is no reason (please!) to think that I would have it (I am so hoping that this is just a strange occurrence).

It does make me think though, since the virus has decided to activate on the trigeminal nerve. Is it because it's damaged in someway? Irritated at the base, not just on the branch where I am having neuralgia but on the other branches as well and virus just took the path of least resistance. Where my body was the weakest? I really don't want to have a paper written on me.


Comment by Richard A. "Red" Lawhern on June 12, 2015 at 11:52am

Tkal, I wish you well with the MVD surgery.  I'm a little surprised that a neurosurgeon would do one while you have active Herpes Zoster virus in your bloodstream.  You might be dealing with a combination of trigeminal neuralgia and post herpetic neuralgia.  Did you have any evident rash anywhere?

On preparation and post-op:  you'll be given a mess of paperwork to fill out before admission.  You'll also need to fast for some period of hours before the surgery.  There will be post-op pain in the incision and generally behind your ear.  You'll be medicated for that pain and you could be sleepy and groggy. You can expect to be in a hospital for three days or so if there are no complications such as a CSF fluid leak.  And you'll want to ask the doctor what follow-up he will do immediately post-op and during your stay, to ensure that you don't have such complications. 

When you get home, your recovery time without complications can vary from a couple of weeks to six weeks or longer.  No real way to tell, but you'll need to plan for family support at home, or an alternative if you don't have someone to do meals and generally check up on you.  Many MVD patients report walking out of the hospital pain free, but that isn't universal.  It can take up to six months for the nerve to settle down once it has been manipulated during the exploration phase of the surgery.  Be aware that even if no compressions were seen in MRI, they are found in almost all patients who have the electric shock stab attacks of classic TN.

I hope this is at least generally helpful.  I encourage others who have had MVD to share their experiences.

Regards, Red

Comment by tkal on June 12, 2015 at 11:34am

After 3 years on different meds I finally got a consult with a neurosurgeon (I have Kaiser insurance). That was two weeks ago. I did my homework, I was ready to argue my case. Etc. He came in, we made introductions. I started with. "I want a MVD. I need a MVD." He smiled. "Well, that makes our conversation a lot shorter because I think that's the way to go in your case too." That was it.

He answered all my questions and told me about his patients that had problems after he performed their surgeries etc.

There was only one problem, not really for my surgery which is scheduled for the first week in July, but for me. I actually got and have shingles on my face, on the side where my TN is now. It's on a different branch. But it has triggered two attacks in the last two weeks.

The surgeon had never heard of it ever happening.  Why I would get shingles on the same trigeminal nerve. If it had been on the same branch, I probably would be in a coma right now.

If I had any doubts about MVD I don't anymore.

Anyway. I'm 47 probably have had TN for about 6 years. Lots of dental work due to pain that wasn't the teeth. My MRI came back clean. The surgeon didn't even comment about that. Told him I was concerned that some surgeons don't look at the entire nerve and miss small compressions if they just find one big one. He was kind, and assured me he always carefully looks at the entire nerve. But there is always the possibility he could have to go back in.

I'm trying to find information on how to prepare for before and after MVD. Paperwork? Tips? What not to do? What kind of pain, headaches, etc are normal? I'll start looking at older posts. But any info would be appreciated. I also have Medicare - hospitalization part. 


Comment by Edster on February 13, 2015 at 12:10pm
Hi I am having burning pain around my cranie site I am wondering what is going on a year and half latter. I would appreciate any feedback
Thanks everyone !

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