Intraoperative monitoring of sensory part of the trigeminal nerve using blink reflex during microvascular decompression for trigeminal neuralgia

Acta Neurochir (Wien). 2018 Jan;160(1):165-169. doi: 10.1007/s00701-017-3405-8. Epub 2017 Nov 25.

Abstract

Intraoperative monitoring during cerebellopontine angle surgery is widely accepted. While techniques which monitor cranial motor nerves are commonly used, monitoring the sensory afferents has been challenging. Considering the reflex arc, blink reflex (BR) might be useful in monitoring the sensory part of the trigeminal nerve, the brainstem connections and the facial nerve. We describe the case of a patient who developed hemifacial hypoesthesia after microvascular decompression surgery for trigeminal neuralgia. Intraoperative BR showed a severe loss of R1 amplitude. BR might be a useful intraoperative technique to monitor the sensory part of the trigeminal nerve.

Keywords: Blink reflex; Intraoperative monitoring; Microvascular decompression; Trigeminal nerve.

Publication types

  • Case Reports

MeSH terms

  • Blinking*
  • Humans
  • Male
  • Microvascular Decompression Surgery / methods*
  • Middle Aged
  • Monitoring, Intraoperative / methods*
  • Trigeminal Nerve / surgery
  • Trigeminal Neuralgia / physiopathology
  • Trigeminal Neuralgia / surgery*