The contribution of Sekula et al.1 highlights several aspects of the surgical treatment of trigeminal neuralgia (TN) that are worthy of consideration and discussion. Their paper continues a previous theme of microvascular decompression (MVD) in the elderly.2 Their thesis is strengthened by a prospective design and a more discrete, standardized classification of the facial pain syndromes and postoperative outcomes.
Several limitations of the study are apparent. Their prospective series is small and the follow-up is short, although the authors concede both of these points. Further, the literature review is not independent of their current prospective series
SekulaRFJrFredricksonAMJanettaPJQuigleyMRAzizKM: Microvascular decompression for elderly patients with trigeminal neuralgia: a prospective study and systematic review with meta-analysis. Clinical article. J Neurosurg[epub ahead of print July 23 2010. DOI: 10.3171/2010.6.JNS10142]