Table 1 Overview of epidemiologic data, case history, MRI findings, treatment and outcome of the patients
No. | Age/sex | Duration of disease (years) | Clinically affected cranial nerves | Main pain manifestation | Clinical findings | 3D Visualzation: neurovascular contact | Course of the disease | Medical treatment previous to MVD | Operation performed | Course of the disease following MVD |
|---|---|---|---|---|---|---|---|---|---|---|
1 | 68/m | 10 | Right IX, X | Pharyngeal, otalgic | CNE unremarkable | Compression of CN IX, X by PICA. VA ectasia and elongation on both sides | Under medical treatment, usually free of pain | CBZ | Not done | MVD not done |
2 | 54/m | 1 | Left IX | Pharyngeal | CNE unremarkable, hypertension | Compression of CN IX, X by the VA and PICA | Initial improvement by medical treatment; during the course of disease loss of effectiveness of medical treatment | CBZ | MVD 2003 | Transient hoarseness, normalization of hypertension, sustained pain-free status |
3 | 45/f | 2 | Right IX, X | Pharyngeal, otalgic, additional constant pain in the left side of the face and the incisors | CNE unremarkable | Compression of the CN IX, X by PICA | Refractory to medical treatment | Not known | MVD 2004 | Transient CSF hypersecretion, pulmonary embolism postoperatively, slight dropping of the palate to the right side, transient recurrent paresis. Pain free during the first week after surgery, afterward persistent dysesthesia of the cervical area on the right side |
4 | 44/f | 2 | Left IX, X | Pharyngeal, later on additional vagal manifestation with cough and hoarseness during pain attacks | CNE unremarkable | Compression of the CN IX, X by PICA | During course of disease refractory to medical treatment | Gabapentin, pregabalin | MVD 2005 | Transient CSF hypersecretion, sustained pain reduction, but not pain free. Transient recurrent paresis on the left |
5 | 58/f | 18 | Left IX | Pharyngeal, otalgic | Hypesthesia of the right face, decrease of the right corneal reflex | Compression of the CN IX by PICA | During course of disease refractory to medical treatment | CBZ, gabapentin, pregabalin | MVD 1999 and 2005 | Pain-free status for 2 years after the first MVD. Sustained pain-free status after the second MVD. Nonrecurring epileptic seizure after the second MVD |
6 | 39/m | 5 | Left IX | Pharyngeal, otalgic | CNE unremarkable | Compression of the CN IX, X by PICA | Initially complete pain control by CBZ, later on refractory to medical treatment and increase of attack frequency | CBZ, gabapentin | MVD 2005 | Sustained pain free, no complications |
7 | 52/f | 1 | Left IX | Pharyngeal, otalgic | CNE unremarkable | Compression of the CN IX, X by PICA | Refractory to medical treatment, weight loss due to inability of regular food intake | Flupirtine, pregabalin | MVD 2005 | Sustained pain-free status, no complications |
8 | 57/m | 3 | Left V, IX | Pharyngeal, trigeminal | CNE unremarkable, hypertension | Compression of the CN IX, X by VA and compression of CN V by AICA | Initially trigeminal neuralgia, later on additional glossopharyngeal neuralgia refractory to medical treatment | Intolerability of CBZ, then on combination of topiramate, pregabalin, gabapentin, and amitriptyline | MVD 2007 | Sustained pain-free status, transient recurrent paresis on the left side, dropping of the palate on the left |
9 | 55/m | 13 | Left IX | Pharyngeal | CNE unremarkable | Compression of the CN IX, X by PICA | Initially good improvement by medical treatment, later on refractory to medical treatment | CBZ, gabapentin | MVD 2007 | Sustained pain-free status, no complications |
10 | 71/f | 1 | Left V, IX | Pharyngeal, otalgic | Hypesthesia in the face on the left side (caused by previous thermocoagulation of the ganglion Gasseri), vertigo, deafness on the left side | Compression of the CN IX, X by PICA | Initially left-sided trigeminal neuralgia, pain-free status for 5 years after thermocoagulation, MVD 19 years after onset of disease, followed by glossopharyngeal neuralgia. Second to MVD 20 years after onset of disease | CBZ | MVD 1992 and 1995 | Sustained pain-free status, no complications |
11 | 67/f | 14 | Right IX | Pharyngeal, otalgic | Pharyngeal and palatinal hypesthesia, hypertension | Compression of the CN IX, X by PICA | Initially good response to CBZ, later on refractory to medical treatment | CBZ | MVD 1996 | Sustained pain-free status, no complications |
12 | 63/f | 7 | Left IX | Pharyngeal, otalgic | CNE unremarkable | Compression of the CN IX, X by PICA | Initially good response to CBZ, later on refractory to medical treatment | CBZ | MVD 2000 | Sustained pain-free status, no complications |
13 | 58/m | 6 | Left IX | Pharyngeal | CNE unremarkable | Compression of the CN IX, X by PICA | Initially good response to medical treatment, pain-free status for 2 years, then refractory to medical treatment | CBZ, gabapentin, tramadol | MVD 2000 | Sustained pain-free status, no complications |
14 | 46/m | 20 | Left IX | Pharyngeal | CNE unremarkable | Compression of the CN IX, X by PICA | Initially good response to medical treatment, later on refractory to treatment | CBZ, gabapentin | MVD 2007 | Sustained pain-free status, transient dysphagia |
15 | 86/m | 3 | Right IX | Pharyngeal, otalgic, additional pain at the right throat | CNE unremarkable, hypertension | Compression of the CN IX, X by PICA | Refractory to medical treatment during the course of disease | CBZ, gabapentin, opioids | MVD 2009 | Sustained pain-free status, no complications |
16 | 55/m | 1 | Left IX | Pharyngeal, laryngeal | CNE unremarkable | Compression of the CN IX, X by PICA | Initially responsive to CBZ but with side effects, no satisfactory response to pregabalin | CBZ, pregabalin | MVD 2008 | Sustained pain-free status, no complications |
17 | 36/f | 3 | Right IX | Pharyngeal, laryngeal, otalgic | CNE unremarkable | Compression of the CN IX, X by PICA | 2001 trigeminal neuralgia left sided, 2005 trigeminal neuralgia right sided, initially responsive to CBZ | CBZ | MVD 2001 (left V), MVD 2005 (right V), MVD 2008 (right IX and X) | Transient hoarseness, sustained pain-free status |
18 | 49/m | 5 | Right IX | Pharyngeal, otalgic | CNE unremarkable | Compression of the CN IX, X by PICA | Initially responsive to CBZ, later on refractory to medical treatment | CBZ, gabapentin, pregabalin, amitriptyline, opioids | MVD 2007 not successful, MVD 2008 | Sustained pain-free status, no complications |
19 | 47/m | 12 | Right IX | Pharyngeal, otalgic | CNE unremarkable, hypertension | Compression of the CN IX, X by PICA and VA ectasia | Tonsillectomy was not successful as initial treatment, later on refractory to medical treatment | CBZ, gabapentin | MVD 2008 | Sustained pain-free status, no complications |