As with the other procedures, pain can return after an MVD. When the pain does come back, it tends to come back soon after surgery. Several studies have found that more than half the people whose pain recurs after an MVD have pain within the first two years. Long-term studies have found that the pain recurrence rate goes down as time passes.
On average, about six percent of MVD patients get recurrence in the first year, three percent a year get it in years two through four, fewer than two percent get pain back in years five through nine, and fewer than one percent get it in year 10. One recent review noted recurrent symptoms typically occur after a mean of 1.9 pain-free years, with a yearly recurrence risk of one to four percent.
Refractory and recurrent symptoms can occur after radiosurgery or radiofrequency ablation. After ablation, 21 to 50 percent of patients have recurrent TN and 15 percent require retreatment. After radiosurgery, approximately 13 to 22 percent of patients require repeated treatment for recurrent symptoms.
Counting the initial failures along with those who have pain recurrence, one pain specialist came up with the following prospects for MVD patients: 81 percent will be pain-free at two years, 76 percent will be pain-free at five years, and 71 percent will be pain-free at 10 years. Initial failures may happen for several reasons, such as the surgeon was unable to find the offending vessel (or vessels), the nerve wasn’t sufficiently cushioned, or the patient didn’t have TN in the first place.
When pain recurs, it is not because the effects of the MVD ‘wear off’. Rather, the most likely reason is that a divided vein sends out new branches and sets up a compression problem all over again. Or it could be that a different blood vessel elongates with age and causes an altogether new compression point. And sometimes these vessels don’t cause a new compression but instead push away the implanted cushion from between the nerve and the vessel.
Other possible causes of pain recurrence include adhesions that form to cause new damage to the trigeminal nerve or failures of the implant. (Adhesions are fibrous growths that sometimes occur along with scar tissue around the surgical site and implanted pad. Implants occasionally can be absorbed by the body – one example of failure.)
In one long-term study, patients with vein compressions were more likely to have a recurrence of pain. Also, female patients and those who did not get immediate pain relief from the MVD were slightly more likely to have pain return. Although MVDs can be done following other procedures that have failed, the success rates are reportedly lower, but several recent papers did not support that concern.
The best MVD results come when MVD is the first procedure. Repeated MVDs also can be done following a failed MVD. Those success rates also are a bit lower than the first surgery – around 80 percent compared to the 85 to 95 percent range for first- time patients.
Data from MVD Pioneer Dr. Peter Jannetta
Of 1,185 patients on whom he performed an MVD:
Of the 132 patients (11%) who required reoperation:
A study from the Netherlands likewise showed an 11% incidence of repeat MVD surgery. One year after surgery, 66% were free of pain and off medicine, and another 10% required some medicine. Their results were thus quite similar to those of Dr. Jannetta.
Dr. Jannetta noted that veins and smaller arteries were the most common findings present at a second surgery. He also mentioned that the presence of venous compression at the first surgery leads to a higher risk of recurrence. The Netherlands series noted that in 61% of repeat operations, no compression was found. They removed the Teflon pad and suspected that the pad itself had devolved into a form of granuloma and was the cause of pain.
Repeat MVD was associated with a higher incidence of facial numbness (8%) than at the first operation (1%) in Dr. Jannetta’s series. In the Netherlands series, it was 27% because of more extensive exploration.
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In January, the Facial Pain Association held a two-day virtual conference bringing together the worldwide facial pain community for a full weekend of educational presentations by renowned experts in neurosurgery, […]
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The Young Patients Committee (YPC) assists in fulfilling the mission of FPA by representing the interests of neuropathic facial pain patients under the age of 40. In 2021, YPC launched […]
The Young Patients Committee (YPC) assists in fulfilling the mission of FPA by representing the interests of neuropathic facial pain patients under the age of 40. In 2021, YPC launched […]
The FPA does not endorse any product, doctor, procedure, medical institution, or its staff.
The FPA does not endorse any product, doctor, procedure, medical institution, or its staff.
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Researchers from Massachusetts General Hospital and Harvard Medical School are conducting a study aiming to Researchers from Massachusetts General Hospital and Harvard Medical School are conducting a study aimed at understanding […]
Presented by Beth Darnall, PhD, Professor of Anesthesiology, Perioperative and Pain Medicine, Director of the Stanford Pain Relief Innovations Lab, and an FPA Medical Advisory Board Member. Although the video […]
You’re Not Alone. Call the Facial Pain Association: 800-923-3608 Email the Facial Pain Association: [email protected] Get support and information tailored to you by filling out a Custom Help Form: https://www.facepain.org/find-support/custom-help/ […]
This holiday season, as we pause to reflect on the lessons learned and the progress made this year, I want to express our deepest gratitude for your unwavering support. The […]
The Young Patients Committee (YPC) assists in fulfilling the mission of FPA by representing the interests of neuropathic facial pain patients under the age of 40. In 2021, YPC launched […]
The Young Patients Committee (YPC) assists in fulfilling the mission of FPA by representing the interests of neuropathic facial pain patients under the age of 40. In 2021, YPC launched […]
As we stand on the threshold of a new year, I want to take a moment to reflect on the strength of the facial pain community. You offer one another […]
An Update on Medical Treatment of Facial Pain (Trigeminal Nerve Pain and Other Nerve/Craniofacial Pain Disorders) is presented by Wolfgang Liedtke, MD, PhD, Chair of Neurology, Psychiatry, Pain Medicine, and […]
UPDATE: October 23, 2024 Sprint for Women’s Health Announces Awardees, Featuring Project on Quantifying Neuropathic Pain The Advanced Research Projects Agency for Health (ARPA-H) has unveiled the awardees of the […]
We are a community because we share some very important things: We either share the experience of having this terrible pain or helping someone who does; we share the need […]
Every January, many people look forward to the new year with hopes and dreams, goals and objectives. The Facial Pain Association (FPA) is no different. We have spent the last […]
The FPA congratulates Dr. Liedtke on his election to the American Clinical and Climatological Association “Wow I’m in!” — it immediately hit me when I recently opened an e-mail from […]
Features MAB Corner: The FPA congratulates Dr. Liedtke on his election to the American Clinical and Climatological Association Medical Article: What is an Orofacial Pain Dentist? Also included: Click here […]
The Facial Pain Association (FPA) is the largest patient organization supporting all people affected by neuropathic facial pain, leading the world in resources for information and healthcare guidance. Through educational […]
My name is Christine Cohen, and I have trigeminal neuralgia, geniculate neuralgia, occipital neuralgia, Eagle’s Syndrome, and Arnold Chiari malformation. Each one of these medical conditions is considered rare. During […]
Decades ago, when I started my dental practice, I occasionally encountered perplexing patient pain issues. More than once I completed what I believed to be a successful root canal treatment, […]
When I chose to do a residency in neurosurgery, it had a well-deserved reputation for being a brutally intense experience. In a class of one hundred medical student graduates, on […]
Juan M. Hincapie-Castillo, PharmD, MS, PhD, an Assistant Professor of Epidemiology at the Gillings School of Global Public Health at the University of North Carolina Chapel Hill, received a 5-year […]
Decision Making: Surgical and Ablative Procedures for Facial Pain is presented by Richard Zimmerman, MD, Professor of Neurosurgery at Mayo Clinic and an FPA Medical Advisory Board Member. Although the […]
Dr. Wolfgang Liedtke is an Executive with Regeneron Pharmaceuticals (Tarrytown, NY) in Genetic Medicines in their Global Clinical Development Unit, and member of their Scientific Council where he is Chair of Neurology, […]
February 29, 2024 The Facial Pain Association (FPA) has co-signed a letter from the Alliance for Connected Care, urging Congress to extend telehealth access permanently. The FPA is committed to […]
Repeat MVDs is presented by Mark Linskey, MD, Professor of Neurological Surgery at the University of California Irvine School of Medicine and an FPA Medical Advisory Board Member. Although the […]
Brandi Underwood, Manager of Development, Research, and Advocacy, represented the Facial Pain Association at the 17th Annual Headache on the Hill by the Alliance for Headache Disorders Advocacy (AHDA) on […]
Features MAB Corner: How to Identify and Combat Medical Misinformation Medical Article: What You Need to Know About Using Medical Marijuana for Facial Pain Also included: Click here to access […]
By Jeffrey Fogel, MD, Member of the FPA Board of Directors Dr. Jeffrey Fogel is an FPA Board Member and pediatrician who was diagnosed with trigeminal neuralgia (TN) in 2008 […]
Kenneth F. Casey, MD Have you heard that white potatoes are bad for you? Or that going out in the cold without a jacket will make you sick? Medical misinformation […]
Advocacy lies at the core of our mission. Through educational resources and volunteer support, the FPA empowers the facial pain community to advocate for themselves and one another. From using […]
Worrying about your next pain flare and how people may perceive you when experiencing facial pain is common in the facial pain community. Due to their nature, facial pain episodes […]
What’s on the Horizon: Pain Management, Neuromodulation, and New Drugs for TN is presented by Raymond F. Sekula, Jr., MD, and Christopher J. Winfree, MD. Although the video is not […]
Advocacy— it’s part of our mission at the Facial Pain Association, but what does it mean? Well, this year, it means a whole lot more. As a community, we have hit […]
Dedicated to advancing the understanding and treatment of neuropathic facial pain, the Facial Pain Association (FPA) provides non-financial support of research efforts, including letters of support, community survey data, patient […]
The Autonomic Effects of Trigeminal Nerve Injury is presented by Jeffrey Brown, MD. Now retired, Dr. Brown previously served as the Neurosurgery Director of the CyberKnife Program at NYU Langone […]
The Young Patients Committee (YPC) assists in fulfilling the mission of FPA by representing the interests of neuropathic facial pain patients under the age of 40. In 2021, YPC launched […]
The Young Patients Committee (YPC) assists in fulfilling the mission of FPA by representing the interests of neuropathic facial pain patients under the age of 40. In 2021, YPC launched […]
The Autonomic Effects of Trigeminal Nerve Injury is presented by Gary L. Stanton, MD, a neurologist at Emerson Health. Although the video is not live, we encourage you to comment […]
The Facial Pain Association (FPA) is the largest patient organization supporting all people affected by neuropathic facial pain, leading the world in resources for information and healthcare guidance. Through programs of […]
Features MAB Corner: Persistent Idiopathic Facial Pain Patient Perspective: Deep Brain Stimulation Medical Article: Neuromodulation for Persistent Idiopathic Facial Pain Sponsor Spotlight: Mayo Clinic From the YPC: Facial Pain Resiliency […]
The challenge for patients with facial pain is that diagnoses such as trigeminal neuralgia (TN), persistent idiopathic facial pain, type I/II TN are all clinical diagnoses. There are no blood […]
Mary Rice I was always active and healthy. I ran 5k races and loved taking photographs of the beach in my hometown of Ocean County, New Jersey. I pursued a […]
Pain is the body’s alarm system. It detects situations when the body is being harmed and signals that it is time to escape from danger or rest after an injury. […]
Sponsor Spotlight: Mayo Clinic Mayo Clinic’s multidisciplinary team approach means people with facial pain receive care based on their individual needs. A team of specialists takes time to thoroughly examine […]
Advocacy 101: What is Advocacy and Why Does it Matter? is presented by Julienne Verdi, JD, Executive Director of the Alliance for Headache Disorders Advocacy (AHDA). Although the video is […]
Abstract In response to “Trigeminal neuralgia: drug therapy: The new German guideline”, a 17-year single center experience (Duke University Medical Center) with over 5000 treated patients is shared. Recommendations as […]
Dr. Jonathan Greenberg, Assistant Professor of Psychology at Harvard Medical School and a Research Staff Psychologist at Massachusetts General Hospital, has received a 2-year Exploratory/Developmental Research Grant (R21) award from […]
Although the video is not live, we encourage you to comment and ask questions. Your participation and feedback will help us gauge interest in a variety of topics to better […]
Noema Pharma is conducting a clinical trial to evaluate the effect of basimglurant for the management of pain in patients with trigeminal neuralgia. Is this clinical trial right for you? […]
October 1, 2024 FOR IMMEDIATE RELEASE Facial Pain Association Releases Second Book to Support Neuropathic Facial Pain Community Suwanee, GA – The Facial Pain Association (FPA) is proud to announce […]
Patient advice: If you are experiencing an acute attack of pain symptoms, remember that narcotics usually will not work to relieve your pain. Furthermore, you may not be able to […]
Buildings and monuments around the world are lighting up teal to show support for those living with neuropathic facial pain. This is a rolling list that will continue to be […]
We are joining the Alliance for Headache Disorders Advocacy (AHDA) in thanking the nearly 175 advocates from 40 states who completed over 200 Congressional meetings on September 24 for Headache […]
Dr. Raymond Sekula gives a special presentation on “A Path for Pain Relief,” discussing the patient journey and treatment options, from medications to surgical procedures and more. Raymond F. Sekula […]
Features MAB Corner: Controlling Chronic Pain from the Outside Medical Article: Developing a Personalized Treatment Approach for Trigeminal Neuralgia Using Gamma Knife Radiosurgery Patient Perspective: Visiting the Emergency Room Sponsor […]
It is estimated that 150,000 people each year are diagnosed with trigeminal neuralgia (TN) (Pilitsis, 2024). If you are one of those suffering from TN, also known as tic douloureux, […]
The FPA’s Video Series featuring presentations from the 2024 FPA Conference continues with Medications to Treat Facial Pain presented by Wolfgang Liedtke, MD, PhD. Dr. Liedtke is the Chair of […]
Jackie Galgey, a well-known children’s author and most recently a contestant on the game show Password, shares her journey of maintaining a successful career, traveling, and parenting while living with […]
Kenneth F. Casey, MD Medical Advisory Board Member For decades, technology has enabled medicine to evolve and change. In our lifetimes, we have seen breakthroughs in surgical devices used to […]
The FPA Video Series featuring presentations from the 2024 FPA Conference continues with Trauma and the Experience of Facial Pain presented by Leesa Scott-Morrow, PhD, JD, LP. Dr. Scott-Morrow is a […]
Ronald E. Warnick, MD Mayfield Brain & Spine New study led by Mayfield neurosurgeon outlines a pathway to pain relief and reduced medication use Gamma Knife radiosurgery is a non-invasive […]
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