{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:39:07Z","timestamp":1781653147119,"version":"3.54.5"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Trigeminal neuralgia (TN) is a rare disorder, affecting 4\u201313 per 100,000 people annually. Only 1%\u20131.5% of these cases are reported before the age of 18 years. The initial management of pediatric TN is based on symptomatic treatment, using first-line medications including carbamazepine, based on data from adult treatment studies. Many of these children are refractory to medication and undergo excessive workup and ineffective therapies before neurosurgical referral. The objective of this study was to perform a comprehensive review of literature-reported pediatric-onset TN, analyzing demographics, diagnostic practices, and complications in this population.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>An institutional, retrospective chart review was performed to identify patients younger than 18 years old who were diagnosed with classic TN and referred for surgical evaluation at Oklahoma Children\u2019s Hospital (OCH). A systematic review of all pediatric patients undergoing microvascular decompression (MVD) for pediatric-onset TN was also performed.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Three patients from OCH were identified, ranging in age from 3 to 11 years. All 3 patients had received multiple ineffective medical therapies before referral for neurosurgical evaluation. In 2 cases, imaging demonstrated potential vascular compression of the trigeminal nerve. In the final case, imaging demonstrated no vascular compression, but compression was found at the time of MVD. All cases were successfully treated using MVD. The literature review identified 49 cases of pediatric TN treated using MVD. All 49 cases were identified as classic TN with neurovascular compression demonstrated either on imaging or found at the time of surgery. The average age at symptom onset was 11.72 years, while the average age at MVD was 19.6 years. The average duration of symptoms before undergoing MVD was 8.2 years. There was a female predominance in the literature review, with a female-to-male ratio of 1.88:1. The right side was involved in 56% of cases, the left side in 40%, and bilateral involvement occurred in 4% of cases. The most common distribution of TN was both V2\/3 branches (38%) of the trigeminal nerve, followed by solely the V2 branch (22%). A successful outcome (Barrow Neurological Institute pain intensity score of I or II) was reported in 79% of patients at the last follow-up (mean 69.1 months).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>There are currently no guidelines for diagnosing or treating pediatric TN. MVD is a safe and effective option in this patient population. Early evaluation for surgical intervention could be critical for early pain relief and reduced disease morbidity.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.4.peds22494","type":"journal-article","created":{"date-parts":[[2023,6,18]],"date-time":"2023-06-18T11:45:11Z","timestamp":1687088711000},"page":"384-393","source":"Crossref","is-referenced-by-count":5,"title":["Treatment of pediatric trigeminal neuralgia with microvascular decompression: a case series and systematic review"],"prefix":"10.3171","volume":"32","author":[{"given":"Audrey A.","family":"Grossen","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Section of Pediatric Neurosurgery, Oklahoma Children\u2019s Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney R.","family":"Iser","sequence":"additional","affiliation":[{"name":"Neurology, University of Oklahoma Health Sciences Center;"},{"name":"Department of Neurology, Section of Pediatric Neurology, Oklahoma Children\u2019s Hospital, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy B.","family":"Leming","sequence":"additional","affiliation":[{"name":"Neurology, University of Oklahoma Health Sciences Center;"},{"name":"Department of Neurology, Section of Pediatric Neurology, Oklahoma Children\u2019s Hospital, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virendra R.","family":"Desai","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Section of Pediatric Neurosurgery, Oklahoma Children\u2019s Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepti G.","family":"Chrusciel","sequence":"additional","affiliation":[{"name":"Neurology, University of Oklahoma Health Sciences Center;"},{"name":"Department of Neurology, Section of Pediatric Neurology, Oklahoma Children\u2019s Hospital, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Emerg Med Clin North Am","first-page":"577","article-title":"Extraoral facial pain","volume":"18","author":"Montgomery MT","year":"2000","unstructured":"Montgomery MT. Extraoral facial pain. Emerg Med Clin North Am. 2000;18(3):577-600,vii-viii."},{"issue":"2","key":"b2","series-title":"Neurol Clin","first-page":"305","article-title":"Trigeminal neuralgia and related disorders","volume":"7","author":"Fromm GH","year":"1989","unstructured":"Fromm GH. Trigeminal neuralgia and related disorders. Neurol Clin. 1989;7(2):305\u2013319."},{"issue":"suppl 2","key":"b3","series-title":"Neurol Sci","first-page":"s101","article-title":"Facial pain in children and adolescents","volume":"26","author":"Grazzi L","year":"2005","unstructured":"Grazzi L, Usai S, Rigamonti A. Facial pain in children and adolescents. Neurol Sci. 2005;26(suppl 2):s101-s103."},{"issue":"3","key":"b4","series-title":"J Craniomandib Disord","first-page":"213","article-title":"Trigeminal neuralgia and its treatment in a 13-month-old child: a review and case report","volume":"5","author":"Mason WE","year":"1991","unstructured":"Mason WE, Kollros P, Jannetta PJ. Trigeminal neuralgia and its treatment in a 13-month-old child: a review and case report. J Craniomandib Disord. 1991;5(3):213\u2013216."},{"issue":"4","key":"b5","series-title":"Neurosurgery","first-page":"804","article-title":"Microvascular decompression for pediatric onset trigeminal neuralgia","volume":"43","author":"Resnick DK","year":"1998","unstructured":"Resnick DK, Levy EI, Jannetta PJ. Microvascular decompression for pediatric onset trigeminal neuralgia. Neurosurgery. 1998;43(4):804\u2013808."},{"issue":"1","key":"b6","series-title":"Syst Rev","first-page":"1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher D","year":"2015","unstructured":"Moher D, Shamseer L, Clarke M,  Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1."},{"issue":"4","key":"b7","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1013","article-title":"Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of The Barrow Neurological Institute","volume":"47","author":"Rogers CL","year":"2000","unstructured":"Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of The Barrow Neurological Institute. Int J Radiat Oncol Biol Phys. 2000;47(4):1013\u20131019."},{"issue":"4","key":"b8","series-title":"J Med Life","first-page":"383","article-title":"Pain in trigeminal neuralgia: neurophysiology and measurement: a comprehensive review","volume":"6","author":"Kumar S","year":"2013","unstructured":"Kumar S, Rastogi S, Kumar S, Mahendra P, Bansal M, Chandra L. Pain in trigeminal neuralgia: neurophysiology and measurement: a comprehensive review. J Med Life. 2013;6(4):383\u2013388."},{"issue":"3","key":"b9","series-title":"J Neurosurg","first-page":"424","article-title":"Atypical trigeminal neuralgia in a 6-year-old boy. Case report","volume":"56","author":"Roski RA","year":"1982","unstructured":"Roski RA, Horwitz SJ, Spetzler RF. Atypical trigeminal neuralgia in a 6-year-old boy. Case report. J Neurosurg. 1982;56(3):424\u2013425."},{"issue":"4","key":"b10","series-title":"Arch Dis Child","first-page":"311","article-title":"Neurovascular compression of the trigeminal and glossopharyngeal nerve: three case reports","volume":"82","author":"Childs AM","year":"2000","unstructured":"Childs AM, Meaney JF, Ferrie CD, Holland PC. Neurovascular compression of the trigeminal and glossopharyngeal nerve: three case reports. Arch Dis Child. 2000;82(4):311\u2013315."},{"issue":"11","key":"b11","series-title":"Przegl Lek","first-page":"952","article-title":"Trigeminalgia caused by neurovascular compression in 12 years old girl","volume":"64","author":"Steczkowska M","year":"2007","unstructured":"Steczkowska M, Herman-Sucharska I, Gle\u0144 A, Gergont A, Skowronek-Ba\u0142a B. Trigeminalgia caused by neurovascular compression in 12 years old girl. Article in Polish. Przegl Lek. 2007;64(11):952\u2013955."},{"issue":"6","key":"b12","series-title":"Childs Nerv Syst","first-page":"763","article-title":"Successful vascular decompression in an 11-year-old patient with trigeminal neuralgia","volume":"24","author":"Solth A","year":"2008","unstructured":"Solth A, Veelken N, Gottschalk J, Goebell E, Pothmann R, Kremer P. Successful vascular decompression in an 11-year-old patient with trigeminal neuralgia. Childs Nerv Syst. 2008;24(6):763\u2013766."},{"issue":"12","key":"b13","series-title":"Childs Nerv Syst","first-page":"2123","article-title":"Surgical treatment of pediatric trigeminal neuralgia: case series and review of the literature","volume":"27","author":"Bender MT","year":"2011","unstructured":"Bender MT, Pradilla G, James C, Raza S, Lim M, Carson BS. Surgical treatment of pediatric trigeminal neuralgia: case series and review of the literature. Childs Nerv Syst. 2011;27(12):2123\u20132129."},{"key":"b14","series-title":"World Neurosurg","first-page":"217","article-title":"Surgical management of trigeminal neuralgia in children","volume":"121","author":"Chicoine NH","year":"2019","unstructured":"Chicoine NH, Yaacoub AP, Jea A, Raskin JS. Surgical management of trigeminal neuralgia in children. World Neurosurg. 2019;121:217\u2013221."},{"issue":"4","key":"b15","series-title":"Childs Nerv Syst","first-page":"767","article-title":"Microvascular decompression for pediatric onset trigeminal neuralgia: patterns and variation","volume":"38","author":"Dou NN","year":"2022","unstructured":"Dou NN, Zhong J, Xia L, Li ST. Microvascular decompression for pediatric onset trigeminal neuralgia: patterns and variation. Childs Nerv Syst. 2022;38(4):767\u2013772."},{"issue":"34","key":"b16","series-title":"Br J Surg","first-page":"306","article-title":"A case of trigeminal neuralgia in a boy, age 10 years, treated by intracranial division of the second and third divisions of the nerve","volume":"9","author":"Barclay JH","year":"2005","unstructured":"Barclay JH. A case of trigeminal neuralgia in a boy, age 10 years, treated by intracranial division of the second and third divisions of the nerve. Br J Surg. 2005;9(34):306\u2013308."},{"issue":"suppl 3","key":"b17","series-title":"J Neurol Surg B Skull Base","first-page":"e285","article-title":"Pain and psychological distress: effect of microvascular decompression on sleep disorders and obsessions in trigeminal neuralgia","volume":"82","author":"Wang Y","year":"2021","unstructured":"Wang Y, Sun K, Zhang W, Zhang H, Wang C. Pain and psychological distress: effect of microvascular decompression on sleep disorders and obsessions in trigeminal neuralgia. J Neurol Surg B Skull Base. 2021;82(suppl 3):e285-e294."},{"issue":"3","key":"b18","series-title":"Neurosurgery","first-page":"E628","article-title":"Three-dimensional fast imaging employing steady-state acquisition magnetic resonance imaging for stereotactic radiosurgery of trigeminal neuralgia","volume":"56","author":"Ch\u00e1vez GDC","year":"2005","unstructured":"Ch\u00e1vez GDC, De Salles AAF, Solberg TD, Pedroso A, Espinoza D, Villablanca P. Three-dimensional fast imaging employing steady-state acquisition magnetic resonance imaging for stereotactic radiosurgery of trigeminal neuralgia. Neurosurgery. 2005;56(3):E628."},{"issue":"suppl","key":"b19","series-title":"J Neurosurg","first-page":"185","article-title":"Comparison of the results of 2 targeting methods in Gamma Knife surgery for trigeminal neuralgia","volume":"109","author":"Matsuda S","year":"2008","unstructured":"Matsuda S, Serizawa T, Nagano O, Ono J. Comparison of the results of 2 targeting methods in Gamma Knife surgery for trigeminal neuralgia. J Neurosurg. 2008;109(suppl):185-189."},{"issue":"4","key":"b20","series-title":"J Korean Neurosurg Soc","first-page":"199","article-title":"The treatment outcome of elderly patients with idiopathic trigeminal neuralgia: micro-vascular decompression versus gamma knife radiosurgery","volume":"44","author":"Oh IH","year":"2008","unstructured":"Oh IH, Choi SK, Park BJ, Kim TS, Rhee BA, Lim YJ. The treatment outcome of elderly patients with idiopathic trigeminal neuralgia: micro-vascular decompression versus gamma knife radiosurgery. J Korean Neurosurg Soc. 2008;44(4):199\u2013204."},{"key":"b21","series-title":"Clin Neurol Neurosurg","first-page":"106063","article-title":"Efficacy of microvascular decompression in patients with trigeminal neuralgia with negative neurovascular relationship shown by magnetic resonance tomography","volume":"197","author":"Wei SC","year":"2020","unstructured":"Wei SC, Yu R, Meng Q, Qu C. Efficacy of microvascular decompression in patients with trigeminal neuralgia with negative neurovascular relationship shown by magnetic resonance tomography. Clin Neurol Neurosurg. 2020;197:106063."},{"issue":"2","key":"b22","series-title":"Neurosurgery","first-page":"299","article-title":"Pathological findings associated with trigeminal neuralgia caused by vascular compression","volume":"35","author":"Hilton DA","year":"1994","unstructured":"Hilton DA, Love S, Gradidge T, Coakham HB. Pathological findings associated with trigeminal neuralgia caused by vascular compression. Neurosurgery. 1994;35(2):299\u2013303."},{"issue":"Pt 12","key":"b23","series-title":"Brain","first-page":"2347","article-title":"Trigeminal neuralgia: pathology and pathogenesis","volume":"124","author":"Love S","year":"2001","unstructured":"Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain. 2001;124(Pt 12):2347-2360."},{"issue":"15","key":"b24","series-title":"Neurology","first-page":"1183","article-title":"Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies","volume":"71","author":"Gronseth G","year":"2008","unstructured":"Gronseth G, Cruccu G, Alksne J,  Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology. 2008;71(15):1183\u20131190."},{"key":"b25","series-title":"World Neurosurg","first-page":"e741","article-title":"Preoperative decision-making in microvascular decompression for trigeminal neuralgia: a survey of practicing neurosurgeons","volume":"150","author":"Mooney J","year":"2021","unstructured":"Mooney J, Erickson N, Ilyas A, Tabibian E, Guthrie BL. Preoperative decision-making in microvascular decompression for trigeminal neuralgia: a survey of practicing neurosurgeons. World Neurosurg. 2021;150:e741\u2013e745."},{"issue":"5","key":"b26","series-title":"Pediatr Neurosurg","first-page":"306","article-title":"Trigeminal neuralgia associated with cerebellopontine angle lipoma in childhood","volume":"48","author":"Egemen E","year":"2012","unstructured":"Egemen E, B\u00f6rcek A\u00d6, Karaaslan B, Baykaner MK. Trigeminal neuralgia associated with cerebellopontine angle lipoma in childhood. Pediatr Neurosurg. 2012;48(5):306\u2013309."},{"issue":"7","key":"b27","series-title":"Headache","first-page":"720","article-title":"Trigeminal neuralgia and cerebellopontine-angle lipoma in a child","volume":"41","author":"Raieli V","year":"2001","unstructured":"Raieli V, Eliseo G, Manfr\u00e8 L, Pandolfi E, Romano M, Eliseo M. Trigeminal neuralgia and cerebellopontine-angle lipoma in a child. Headache. 2001;41(7):720\u2013722."},{"issue":"1","key":"b28","series-title":"J Indian Soc Pedod Prev Dent","first-page":"49","article-title":"Reactivation of trigeminal neuralgia following distraction osteogenesis in an 8-year-old child: report of a unique case","volume":"25","author":"Ramanathan M","year":"2007","unstructured":"Ramanathan M, Parameshwaran AA, Jayakumar N, Raghaviah AM. Reactivation of trigeminal neuralgia following distraction osteogenesis in an 8-year-old child: report of a unique case. J Indian Soc Pedod Prev Dent. 2007;25(1):49\u201351."},{"issue":"4","key":"b29","series-title":"Pediatr Neurol","first-page":"309","article-title":"Trigeminal neuralgia in children: two case reports","volume":"26","author":"Lopes PG","year":"2002","unstructured":"Lopes PG, Castro ES Jr, Lopes LHG. Trigeminal neuralgia in children: two case reports. Pediatr Neurol. 2002;26(4):309\u2013310."},{"issue":"2","key":"b30","series-title":"Int J Clin Pediatr","first-page":"74","article-title":"Trigeminal neuralgia: a rare cause of facial pain in a child","volume":"2","author":"Ekici A","year":"2013","unstructured":"Ekici A, \u00cdncesulu A, Yimenicioglu S, Ko\u00e7ak O, Carman K. Trigeminal neuralgia: a rare cause of facial pain in a child. Int J Clin Pediatr. 2013;2(2):74\u201375."},{"issue":"8","key":"b31","series-title":"J Child Neurol","first-page":"989","article-title":"Trigeminal neuralgia due to anterior inferior cerebellar artery loop: a case report","volume":"24","author":"Koul R","year":"2009","unstructured":"Koul R, Alfutaisi A, Jain R, Alzri F. Trigeminal neuralgia due to anterior inferior cerebellar artery loop: a case report. J Child Neurol. 2009;24(8):989\u2013990."},{"issue":"663","key":"b32","series-title":"Postgrad Med J","first-page":"16","article-title":"Long-term treatment of trigeminal neuralgia with carbamazepine","volume":"57","author":"Taylor JC","year":"1981","unstructured":"Taylor JC, Brauer S, Espir ML. Long-term treatment of trigeminal neuralgia with carbamazepine. Postgrad Med J. 1981;57(663):16\u201318."},{"key":"b33","series-title":"Neuroimage Clin","first-page":"710","article-title":"Predicting pain relief: use of pre-surgical trigeminal nerve diffusion metrics in trigeminal neuralgia","volume":"15","author":"Hung PSP","year":"2017","unstructured":"Hung PSP, Chen DQ, Davis KD, Zhong J, Hodaie M. Predicting pain relief: use of pre-surgical trigeminal nerve diffusion metrics in trigeminal neuralgia. Neuroimage Clin. 2017;15:710\u2013718."},{"issue":"5","key":"b34","series-title":"J Korean Neurosurg Soc","first-page":"615","article-title":"Surgical treatment for Trigeminal neuralgia","volume":"65","author":"Park CK","year":"2022","unstructured":"Park CK, Park BJ. Surgical treatment for Trigeminal neuralgia. J Korean Neurosurg Soc. 2022;65(5):615\u2013621."},{"issue":"2","key":"b35","series-title":"Cureus","first-page":"e22548","article-title":"Recurrent trigeminal neuralgia: a case series and a review of the literature","volume":"14","author":"Vardhan H","year":"2022","unstructured":"Vardhan H, Sushmitha S, Nagammai N, Saraswathi K. Recurrent trigeminal neuralgia: a case series and a review of the literature. 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N Engl J Med. 1996;334(17):1077\u20131083."},{"key":"b38","series-title":"Front Neurol","first-page":"864061","article-title":"Microvascular decompression for trigeminal neuralgia caused by venous offending on the ventral side of the root entrance\/exit zone: classification and management strategy","volume":"13","author":"Wang W","year":"2022","unstructured":"Wang W, Yu F, Kwok SC, Wang Y, Yin J. Microvascular decompression for trigeminal neuralgia caused by venous offending on the ventral side of the root entrance\/exit zone: classification and management strategy. 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