Abstract Details

Title Microvascular Decompression for Trigeminal Neuralgia: Assessment of Modality Utility

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P8 - Poster Session 8 (8:00 AM-9:00 AM)

Poster/Presentation
Number 11-030

Objective To evaluate the efficacy of various intraoperative neurophysiological monitoring (IONM) modalities during microvascular decompression (MVD) surgery for trigeminal neuralgia.

Background Trigeminal neuralgia (TN) is a debilitating neuropathic facial pain disorder caused by compression of the trigeminal nerve or its root. MVD is the preferred surgical intervention, offering long-term symptom relief. Given the trigeminal nerve’s proximity to other cranial nerves, precise intraoperative assessment is crucial to protect neural structures and functional integrity.

Design/Methods In a systematic review spanning from 2003 to 2024, 15 studies were analyzed to assess the use of IONM during MVD for TN. Key modalities included somatosensory evoked potentials (SEPs), trigeminal somatosensory evoked potentials (TSEPs), motor evoked potentials (MEPs), compound muscle action potentials (CMAPs), electromyography (EMG), brain auditory evoked potentials (BAEP), and train-of-four (TOF) stimulation.

Results The findings underscored the significance of a multimodal IONM approach, particularly emphasizing the importance of BAEP and EMG in monitoring nerve integrity. SEPs and TSEPs provide vital insights regarding sensory pathways, while MEPs monitor motor function. TOF ensures adequate muscle relaxation, and EMG offers real-time feedback on nerve integrity.

Conclusions

MVD has been shown to be a safe and effective procedure for alleviating neuropathic pain from TN. Furthermore, based on our review, the use of IONM modalities in conjunction with this procedure may significantly reduce postoperative complications. Ongoing research and standardization efforts hold potential for further enhancing surgical interventions for trigeminal neuralgia.

Authors/Disclosures
Unaiza Memon PRESENTER	Dr. Memon has nothing to disclose.
Faisal R. Jahangiri, MD, DABNM, FASNM, FASET	Prof. Jahangiri has nothing to disclose.

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