title: Surgical treatment of pediatric trigeminal neuralgia: case series and review of the literature.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Bender
authors.forename: Gustavo
authors.initials: G
authors.lastname: Pradilla
authors.forename: Carol
authors.initials: C
authors.lastname: James
authors.forename: Shaan
authors.initials: S
authors.lastname: Raza
authors.forename: Michael
authors.initials: M
authors.lastname: Lim
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Carson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D061145:Microvascular Decompression Surgery / Q000379:methods*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery*