Evidence map›Paper›PMID 41102594›Full record

Observational studyJournal of neurology2025

Five-year prospective outcomes of medical management and microvascular decompression in trigeminal neuralgia.

Jacob Worm, Tone Bruvik Heinskou, Per Rochat, Jacob Bertram Springborg, Emil Andonov Smilkov, Lars Bendtsen, Henrik Winther Schytz, Stine Maarbjerg

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jacob WormDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark. jacob.worm@regionh.dk.ORCID http://orcid.org/0000-0002-7201-065X
Tone Bruvik HeinskouDepartment of Neurology, Neuropathic Pain and CRPS Clinic, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.ORCID http://orcid.org/0000-0002-1318-4262
Per RochatDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Jacob Bertram SpringborgDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.ORCID http://orcid.org/0000-0003-0917-3402
Emil Andonov SmilkovDepartment of Radiology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.ORCID http://orcid.org/0009-0002-8026-4307
Lars BendtsenDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark.ORCID http://orcid.org/0000-0002-4810-4998
Henrik Winther SchytzDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark.ORCID http://orcid.org/0000-0002-6262-2986
Stine MaarbjergDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark.ORCID http://orcid.org/0000-0002-3309-6120

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTrigeminal neuralgia is a severe facial pain disorder with major impact on quality of life. Long-term prospective data comparing medical and surgical treatments remain scarce. This study compared 5-year outcomes of medical management and microvascular decompression (MVD) and explored predictors of treatment response.

methodsWe conducted a prospective observational cohort study at a national referral center (2012-2019). Consecutive patients with classical or idiopathic trigeminal neuralgia underwent MRI, baseline assessment, and systematic 5-year follow-up. Treatment allocation (medical therapy or MVD) followed clinical evaluation and international guidelines. The primary outcome was categorized as pain-free without medication, pain-free with medication, continued pain without medication, or continued pain with medication.

resultsOf 626 eligible patients, 227 completed follow-up (95 MVD, 132 medical). Pain-free without medication was achieved in 59% of MVD patients versus 19% of medically treated [relative risk (RR) 3.03, 95% confidence interval (CI) 1.67-5.50]. Pain-free with medication occurred in 1% after MVD versus 14% of the medical cohort (RR 0.16, 95% CI 0.04-0.69). Continued pain on medication was less frequent after MVD (22% vs 49%; RR 0.44, 95% CI 0.24-0.80). Male sex predicted excellent outcome after MVD (odds ratio 2.60, 95% CI 1.02-6.91). Postoperative hypoesthesia occurred in 23% and hearing impairment in 7%, while 55% of medically treated patients reported side effects.

conclusionsMVD provided superior long-term pain relief, higher rates of medication-free pain freedom, and reduced medication use compared with medical management, supporting earlier surgical consideration in selected patients and emphasizing individualized, guideline-based care.

Indexed as

Microvascular Decompression SurgeryTrigeminal NeuralgiaAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesTreatment OutcomeAnticonvulsantsCohort studiesFacial painMDTMultidisciplinaryMVDNeurosurgeryObservational studyPain managementSex differences

Identifiers

PMID41102594
PMCPMC12532645

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.