Jaslok Hospital Achieves Major Milestone in Trigeminal Neuralgia TreatmentJaslok Hospital Achieves Major Milestone in Trigeminal Neuralgia Treatment Jaslok Hospital and Research Centre has successfully treated a rare case of primary bilateral trigeminal neuralgia (PBTN) through bilateral microvascular decompression (MVD). This breakthrough marks the first of its kind in India, bringing hope to patients suffering from this debilitating condition. PBTN is an extremely rare form of trigeminal neuralgia, a chronic pain disorder characterized by sudden, severe facial pain. The condition affects both sides of the face, making it nearly unbearable. A 56-year-old woman from Maharashtra had been suffering from severe PBTN for five years. Despite various medical treatments, she found no relief. The excruciating pain interfered with basic daily activities and led to suicidal thoughts. In October 2023, she was referred to Jaslok Hospital, where Dr. Raghvendra Ramdasi diagnosed her with PBTN. An MRI scan revealed compressed trigeminal nerves on both sides. Dr. Ramdasi and his team performed bilateral MVD, placing Teflon sponges between the nerves and the compressing vessels. The surgery was a success, and the patient experienced complete pain relief. “Bilateral trigeminal neuralgia is a highly painful condition,” said Dr. Ramdasi. “This case marks a significant achievement, demonstrating the importance of accurate diagnosis and specialized care.” The patient, Kiran Awasthi, expressed her gratitude to Dr. Ramdasi, saying, “He has given me a new life.” Jaslok Hospital’s Director of Medical Services, Dr. Milind Khadke, commended the team’s dedication to diagnosing and treating rare cases. He stated, “This successful treatment is a testament to our commitment to providing life-changing results.” The successful treatment of PBTN with bilateral MVD highlights the expertise and technological advancements at Jaslok Hospital. It brings hope to patients suffering from this debilitating condition, offering them the possibility of pain-free living.
Mumbai: Jaslok Hospital and Research Centre is proud to announce a major medical milestone in the diagnosis and treatment of primary bilateral trigeminal neuralgia (PBTN).
A 56-year-old housewife from interior Maharashtra, who suffers from this debilitating condition, has experienced complete pain relief after bilateral microvascular decompression (MVD). This is a major advance in neurosurgery and the first in India.
The patient, with a five-year history of severe, shock-like pain on both sides of her face, experienced excruciating episodes that lasted several minutes and were triggered by daily activities such as talking, eating, brushing teeth and even exposure to a cool breeze. Despite various medical treatments, she found no relief as the disease went undiagnosed. The excruciating pain made it difficult to perform basic household tasks to the extent that it led to the development of suicidal thoughts.
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In October 2023, she was referred to Jaslok Hospital, where Dr Raghvendra Ramdasi diagnosed her with bilateral primary trigeminal neuralgia. An MRI scan showed that her trigeminal nerves (fifth cranial nerve) were compressed by vascular loops on both sides.
Primary bilateral trigeminal neuralgia is extremely rare, with an incidence ranging from 0.6% to 5.9%. To date, only about 24 cases have been reported in the English-language medical literature, with none from India. This case marks the first reported case in India where bilateral MVD was performed, resulting in complete pain relief.
The trigeminal nerve, or fifth cranial nerve, supplies sensation to the face through three divisions. Trigeminal neuralgia is a chronic pain disorder characterized by sudden, severe facial pain, often described as an electric shock. The condition is usually unilateral and affects one or more divisions of the trigeminal nerve. In about 85% of cases, the cause is a vascular loop compressing the nerve at its root entrance.
Although medications such as carbamazepine, gabapentin, lamotrigine, and topiramate can provide relief, microvascular decompression (MVD) remains the gold standard treatment. This surgical procedure involves placing a Teflon sponge between the nerve and the compressing vessel.
Under the guidance of Dr Raghvendra Ramdasi, Consultant Neurosurgery at Jaslok Hospital, the medical team including Dr Poornima Shah, Consultant Neurophysiology, Dr Rajani Prajish, Consultant Anesthesiology, Dr Savi Kapila, Consultant Anesthesiology, performed bilateral microvascular decompression , initially operating on the more severe left side, followed by the right side a week later. After the operation, the patient experienced complete pain relief, which significantly improved her quality of life. Six months later, she continues to live pain-free and can resume normal activities without fear of pain attacks.
Dr. Raghvendra Ramdasi, neurosurgeon at Jaslok Hospital, “Bilateral trigeminal neuralgia is often described as one of the most painful conditions a person can experience. This rare case was accurately diagnosed and therefore treated with precision with bilateral microvascular decompression, the first in India. It is the greatest reward to see our patient regain her quality of life after 5 years and live pain-free. This case highlights the importance of expert diagnosis and the need for specialized care when treating rare conditions.”
Kiran Awasthi said with joy, “Dr. Ramdasi has taken me from the gates of death. I was about to commit suicide because the pain was unbearable. He has given me new life”
Dr. Paresh Doshi, Director of Neurosurgery, Functional Neurosurgery and Stereotactic Neurosurgery, Jaslok Hospital, “The diagnosis of Primary Bilateral Trigeminal Neuralgia (PBTN) is a rare occurrence and the successful completion of bilateral MVD at Jaslok Hospital is definitely a commendable achievement. While the surgical procedure of Bilateral Micro Vascular Decompression (MVD) is well established, Bilateral Decompressive Surgery is uncommon.”
Dr Milind Khadke, Director of Medical Services, Jaslok Hospital, said, “The successful treatment of primary bilateral trigeminal neuralgia with bilateral microvascular decompression, the first in India, is a monumental achievement for Jaslok Hospital. We are proud of our team’s dedication to being vigilant in diagnosing rare cases and delivering life-changing results. I am happy to see our patient walking out pain-free and continuing on in the same vein for months now.”
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