Idiopathic Trigeminal Neuralgia in the Healthy Patient

Abstract: Idiopathic trigeminal neuralgia is one of the most common pain syndromes encountered in a typical neurosurgical practice. The approach to these patients is nuanced, and is based on their overall health status, the characteristics of their pain, and the distribution of symptoms. This chapter describes the assessment of a healthy patient with trigeminal neuralgia and provides key differential diagnoses of this pain syndrome. The counseling of the patient regarding treatment options is also described. Finally, the chapter outlines the operative management of a healthy patient using a microvascular decompression (MVD), including surgical pearls and strategies for complication avoidance and management.