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Surgical treatment of pediatric trigeminal neuralgia: case series and review of the literature

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Abstract

Purpose

Pediatric trigeminal neuralgia (TN) is a rare entity. The purpose of this study was to retrospectively analyze a small series of pediatric patients diagnosed with TN and surgically treated with microvascular decompression (MVD) at a single center.

Methods

Nine patients were identified who presented with TN symptoms that began before the age of 18. Four were excluded because of delayed surgical intervention or successful medical management. We retrospectively reviewed the charts of 5 patients with classical TN who underwent MVD at or before the age of 18.

Results

Patient ages ranged from 3 to 18 years (average, 11.7) at the time of procedure. All five patients were female. Four patients underwent a single procedure and one had bilateral MVDs. In all six cases, vascular compression of the trigeminal nerve was found during surgery. Compression was venous in three cases, arterial in two, and both in one. Pain relief was complete following the procedure in five of six cases. Pain relief was incomplete but substantial in one patient, allowing her to discontinue anticonvulsant medications. Follow-up duration ranges from 9.1 to 24.8 months with an average of 15.3 (± 6.1) and a median of 12.7 months follow-up. There were no complications such as CSF leak, infection, or cranial nerve deficits.

Conclusions

Until now, there had been no reports on the effectiveness of MVD performed before the age of 18 to treat TN. These preliminary results suggest MVD may be performed with good pain relief and minimal side effects in the pediatric population.

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Authors and Affiliations

  1. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Matthew T. Bender, Gustavo Pradilla, Shaan Raza, Michael Lim & Benjamin S. Carson

  2. Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, MD, USA

    Carol James

  3. Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Benjamin S. Carson

  4. Department of Plastic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Benjamin S. Carson

  5. Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Michael Lim & Benjamin S. Carson

Authors
  1. Matthew T. Bender
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  2. Gustavo Pradilla
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  3. Carol James
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  4. Shaan Raza
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  5. Michael Lim
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  6. Benjamin S. Carson
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Correspondence to Benjamin S. Carson.

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Bender, M.T., Pradilla, G., James, C. et al. Surgical treatment of pediatric trigeminal neuralgia: case series and review of the literature. Childs Nerv Syst 27, 2123–2129 (2011). https://doi.org/10.1007/s00381-011-1593-8

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  • DOI: https://doi.org/10.1007/s00381-011-1593-8

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