Trigeminal neuralgia: updated management

The so-called idiopathic trigeminal neuralgia is easily diagnosed by the clinical history of the patient and present a constant cause, a neurovascular conflict in the cerebellopontine angle in the majority of cases, which is clearly identified by MRI assessment. Knowing the cause, after a trial period with a medical treatment, a curative surgical solution can be now offered to the patient when the medications do not provide a pain-free result or when the patients wish a more definitive solution. Combining the use of both operating microscope and endoscope increases the efficiency of the neurovascular decompression and decreases drastically the potential morbidity of the surgical procedure. From 355 patients suffering of trigeminal neuralgia who underwent endoscope-assisted retrosigmoid approach, the authors present their experiences and results.