Trigeminal neuralgia is a uncommon condition characterised by spasms of electric shock like facial pain which comes on spontaneously. The pain is usually brief, triggerable and may spontaneously resolve. There is often no cause identified. Treatment with medication is often helpful initially and may be all that is necessary.
The observation at surgery that an artery would often be seen compressing the trigeminal nerve led neurosurgeons to postulate that vascular compression was the cause of the neuralgia. Removal of the offending vessel from the nerve was performed and patients were relieved of pain. This is the basis of the “neurovascular compression” hypothesisof the cause of the condition and the rationale for the operation microvascular decompression (MVD), still the most effective and durable surgical treatment for this condition.
Today, if medical treatment becomes ineffective, there are a range of neurosurgical operations that are effective for the relief of trigeminal neuralgia. To determine the best one for you talk to your neurosurgeon.