{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:01:36Z","timestamp":1787241696294,"version":"build-2736575974"},"reference-count":90,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Trigeminal neuralgia (TN) is a debilitating condition often associated with multiple sclerosis (MS), in which the presence of demyelinating plaques in the pons can impact the trigeminal nerve. Microvascular decompression (MVD) is the gold-standard surgical treatment for classic TN but is traditionally contraindicated in TN-MS patients due to limited efficacy and concerns over neurovascular compression as the sole etiology. This systematic review aimed to evaluate the outcomes of MVD in TN-MS patients, focusing on pain relief and complications.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A systematic search of the PubMed, Embase, Scopus, and Web of Science databases was conducted in June 2024, adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies reporting on MVD outcomes in TN-MS patients were included. Data on demographics, clinical characteristics, surgical outcomes, and complications were extracted. The primary outcome was long-term pain-free status (Barrow Neurological Institute [BNI] score of I) at the final follow-up. A meta-analysis of proportions was performed using a random-effects model. Risk of bias was assessed using the Methodological Index for Non-Randomized Studies tool.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n From 523 unique records, 30 studies were included, consisting of 429 TN-MS patients treated with MVD, with 265 unique patients. Neurovascular compression was identified in 96.6% of the patients. The pooled success rate of MVD, defined as achieving a BNI score of I, was 30.2% (95% CI 24.2%\u201336.9%). Heterogeneity was low (I\n 2<\/jats:sup>\n = 0%\u201325%) across analyses. The most common complication reported after MVD was transient facial numbness. Publication bias was not significant in the included studies.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n MVD is less effective in TN-MS patients than in those with classic TN, with approximately 30% achieving long-term pain-free outcomes. However, MVD may still offer meaningful relief, particularly in patients with neurovascular compression. Given these findings, MVD should not be categorically excluded as a treatment option for TN-MS. Further prospective studies are needed to refine patient selection and optimize outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.7.jns243258","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T17:26:30Z","timestamp":1765214790000},"page":"1122-1133","source":"Crossref","is-referenced-by-count":3,"title":["Long-term outcomes of microvascular decompression for trigeminal neuralgia in multiple sclerosis: a systematic review and meta-analysis"],"prefix":"10.3171","volume":"144","author":[{"given":"Hadi","family":"Sultan","sequence":"first","affiliation":[{"name":"Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadmahdi","family":"Sabahi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hediye","family":"Gholamshahi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman","family":"Albakr","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, Florida;"},{"name":"Department of Surgery, Division of Neurosurgery, King Saud University, Riyadh, Saudi Arabia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badih","family":"Adada","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Borghei-Razavi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, Florida;"},{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"J Headache Pain","first-page":"20","article-title":"Trigeminal neuralgia secondary to multiple sclerosis: from the clinical picture to the treatment options","volume":"20","author":"Di Stefano G","year":"2019","unstructured":"Di Stefano G, Maarbjerg S, Truini A. 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Pain Manag. 2021;11(5):561\u2013569."},{"issue":"5","key":"b17","series-title":"Cephalalgia","first-page":"3331024231167130","article-title":"Efficacy of surgical treatment in patients with trigeminal neuralgia secondary to multiple sclerosis: a prospective study of 18 cases with evaluation of outcome and complications by independent evaluators","volume":"43","author":"Worm J","year":"2023","unstructured":"Worm J, Noory N, Smilkov EA, Efficacy of surgical treatment in patients with trigeminal neuralgia secondary to multiple sclerosis: a prospective study of 18 cases with evaluation of outcome and complications by independent evaluators. 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