Actual management of essential trigeminal neuralgia

Trigeminal neuralgia is a common cause of facial pain. Pathophysiology considerations, surgical armementorium and results are mentioned. Because none of the currently available techniques is perfect, there is a continuing effort of neurosurgeons to develop new treatment methods. There are: microvascular decompression – which offer the best chance of permanent pain relief without sensory loss or dysesthesia, Gamma knife surgery, but also lesioning techniques. It’s important for each neurosurgeon to be skilled not only in microvascular decompression, but also in at least one of the percutaneous treatment methods: radiofrequency rhizotomy, Gasserian ganglion gycerol injection, balloon compression. In this way treatment should be customized to the individual patient, informing properly of the risks, benefits of the main treatment options, also about the spectrum of technical and human competences localy available.