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Background <p>The role of microvascular decompression (MVD) in patients with multiple sclerosis-related trigeminal neuralgia (MS-TN) remains unclear. Central demyelination is the primary underlying cause of MS-TN, and the absence of vascular compression raises questions about the role of MVD in MS-TN patients. We aimed to evaluate the efficacy and safety of MVD in MS-TN patients.</p> Methods <p>On April 9, 2025, a thorough search was performed, including studies that reported outcomes of MVD in MS-TN patients.</p> Results <p>Fifteen studies involving 230 patients were included. The meta-analysis revealed a pooled pain-free rate of 61% (95% CI: 10%-100%) and an adequate pain relief rate of 99% (95% CI: 93%-100%) at the initial follow-up. Our findings suggested that at the last follow-up, MVD resulted in a pooled pain-free rate of 29% (95% CI: 19%-41%) and an adequate pain relief rate of 76% (95% CI: 61%-89%), with a pooled complication rate of 16% (95% CI: 6%-29%).</p> Conclusion <p>MVD is associated with favorable initial pain-free and adequate pain-relief outcomes, acceptable long-term pain-related outcomes, and a relatively low complication rate. In MS-TN individuals with apparent NVC and no sign of brainstem lesions in the MRI studies, MVD can be associated with more favorable outcomes.</p>

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Efficacy and safety of microvascular decompression in trigeminal neuralgia secondary to multiple sclerosis: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年10月13日

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  • Bardia Hajikarimloo,
  • Salem M. Tos,
  • Ibrahim Mohammadzadeh,
  • Ali Mortezaei,
  • Arman Hasanzade,
  • Dorsa Najari,
  • Azin Ebrahimi,
  • Mohammad Amin Habibi

摘要

Background

The role of microvascular decompression (MVD) in patients with multiple sclerosis-related trigeminal neuralgia (MS-TN) remains unclear. Central demyelination is the primary underlying cause of MS-TN, and the absence of vascular compression raises questions about the role of MVD in MS-TN patients. We aimed to evaluate the efficacy and safety of MVD in MS-TN patients.

Methods

On April 9, 2025, a thorough search was performed, including studies that reported outcomes of MVD in MS-TN patients.

Results

Fifteen studies involving 230 patients were included. The meta-analysis revealed a pooled pain-free rate of 61% (95% CI: 10%-100%) and an adequate pain relief rate of 99% (95% CI: 93%-100%) at the initial follow-up. Our findings suggested that at the last follow-up, MVD resulted in a pooled pain-free rate of 29% (95% CI: 19%-41%) and an adequate pain relief rate of 76% (95% CI: 61%-89%), with a pooled complication rate of 16% (95% CI: 6%-29%).

Conclusion

MVD is associated with favorable initial pain-free and adequate pain-relief outcomes, acceptable long-term pain-related outcomes, and a relatively low complication rate. In MS-TN individuals with apparent NVC and no sign of brainstem lesions in the MRI studies, MVD can be associated with more favorable outcomes.