CNS Neurosurgery    |    MVD for Tic

MVD for Tic

Welcome to Dr Khurana’s MVD / Trigeminal Neuralgia page.

Images shown here are with the permission of Dr Khurana’s patients, for educational purposes.

  • Dr Khurana’s MVD Video can be accessed via the link at the bottom of this page.

Typical trigeminal neuralgia (facial tic) patients suffer from terrible electrical “lancinating” pain in the face. The pain arises from a physical conflict between a brainstem artery (usually one or more branches of the “superior cerebellar artery“) and the trigeminal nerve (Image 1) at its brainstem (pons region) entry region (“root entry zone“).This physical “pulsatile” neurovascular conflict (NVC; Image 2 FIESTA MRI image) causes abnormal (“ephaptic”) transmission in the nerve, and this manifests as the severe bouts of pain that is often triggered by e.g., teeth-brushing, wind on the face, stroking the face, chewing, etc. If the pain does not respond well to medications from your G.P. or neurologist, the condition can be readily treated by an experienced cerebral microsurgeon in an operation referred to as microvascular decompression (MVD).

Patients with trigeminal neuralgia should NOT feel that “nothing can be donefor their pain, NOR should they undergo any potentially destructive radiation of the brain as the first-line treatment, when there is a typically safe and effective time-tested microsurgical solution that does not involve any entry into or destruction of brain tissue. Patients with suspected trigeminal neuralgia should be appropriately imaged to ensure that there is no tooth abscess, or any multiple sclerosis plaque or other structural lesion (tumour or vascular mass) in or near the ‘pons’ causing the facial pain.

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Dr Khurana uses a small incision behind the ear, a small craniotomy, and advanced microsurgical techniques to access and decompress the trigeminal nerve complex.

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The trigeminal nerve is surgically decompressed using a combination of micro-instruments to free up the local neurovascular tissues, followed by placement of tiny (1-1.5mm) pledgets of teflon (PTFE) between the offending vessel(s) and the trigeminal nerve trunk. Dr Khurana’s craniotomy reconstruction techniques are carefully designed to provide structural and cosmetic integrity.

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Click this link to watch Dr Khurana’s MVD / Microsurgery Video (with thanks to Twin Turbo Productions)