Clinical Features of First Division Idiopathic Trigeminal Neuralgia

Kim, Min Soo; Han, In Bo; Huh, Ryoong; Chung, Sang Sup

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2010;6(1):25-27.
Published online June 30, 2010.

Clinical Features of First Division Idiopathic Trigeminal Neuralgia

Min Soo Kim, In Bo Han, Ryoong Huh, Sang Sup Chung

Department of Neurosurgery, Bundang Cha Medical Center, Cha University, Sungnam, Korea

Abstract

Objective
Trigeminal neuralgia (TN) most commonly involves the mandibular division of the trigeminal nerve alone, while the ophthalmic division is less commonly affected alone. The aim of this study was to evaluate the TN in the first division. Materials and Methods: This study was a retrospective study. Between 1992 and 2007, 281 patients underwent surgical procedures for TN. We reviewed 40 patients who had TN in the distribution of the ophthalmic branch of the trigeminal nerve and underwent microvascular decompression (MVD).
Results
Among 40 patients, 4 patients had pure first division TN and always had the compression of superior cerebellar artery on the superomedial surface of trigeminal nerve. In regard to autonomic phenomena, they were not present in our patients. In case of first division TN, we recommended microvascular decompression (MVD). The surgical outcomes were not different from other cases with second or third division.
Conclusion
There is no significant difference between V1 TN and V2 and V3 TN in terms of clinical characteristics and surgical outcomes. However, the destructive surgical procedures may increase the complication rates in V1 TN and MVD is effective for V1 TN. Moreover, the higher the distribution of neuralgic pain, the more frequently the superior location of the compression was.

Key Words: First division, Trigeminal neuralgia.