Jaslok Hospital Achieves India's First Successful Treatment Of Bilateral Trigeminal Neuralgia

Jaslok Hospital and Research Centre has announced a medical achievement in the diagnosis and treatment of Primary Bilateral Trigeminal Neuralgia (PBTN). 

The hospital in a press statement on Thursday informed that the  56-year-old housewife from Maharashtra, suffering from this rare and excruciating condition, has experienced complete pain relief following Bilateral Micro Vascular Decompression (MVD), a  first of its kind in India.

The patient had endured severe, shock-like pain on both sides of her face for five years. These painful episodes were triggered by daily activities such as talking, eating, brushing her teeth, and even exposure to a cool breeze. Despite various treatments, she found no relief until her referral to Jaslok Hospital in October 2023, where Raghvendra Ramdasi diagnosed her with Bilateral Primary Trigeminal Neuralgia. An MRI scan revealed vascular loops compressing her trigeminal nerves on both sides.

Primary Bilateral Trigeminal Neuralgia is extremely rare, with an incidence ranging from 0.6 per cent to 5.9 per cent. Only about 24 cases have been reported in the English medical literature, none from India. This case is the first reported instance in India where a Bilateral MVD was performed, resulting in complete pain relief.

Trigeminal Neuralgia is a chronic pain disorder characterised by sudden, severe facial pain, often described as electric shock-like. It typically affects one side of the face, caused by a vascular loop compressing the nerve. Medications such as Carbamazepine, Gabapentin, Lamotrigine, and Topiramate can offer relief, but Micro Vascular Decompression (MVD) remains the gold standard treatment. This surgical procedure involves placing a Teflon sponge between the nerve and the compressing vessel.

Under the leadership of  Raghvendra Ramdasi, Consultant Neurosurgery at Jaslok Hospital, a medical team including  Poornima Shah, Consultant Neurophysiology, Rajani Prajish, Consultant Anaesthesiology, and  Savi Kapila, Consultant Anaesthesiology performed Bilateral MVD. The procedure was done in two stages, initially on the more severe left side, followed by the right side a week later. Post-surgery, the patient experienced complete pain relief, significantly improving her quality of life. Six months later, she continues to live pain-free, able to resume normal activities without fear of pain attacks.

"Bilateral Trigeminal Neuralgia is often described as one of the most painful conditions a person can experience," stated Dr. Raghvendra Ramdasi. "This rare case was accurately diagnosed and treated with precision. Seeing our patient regain her quality of life after five years and live pain-free is the greatest reward. This case highlights the importance of expert diagnosis and the need for specialised care in managing rare conditions."

The patient expressed her gratitude, saying, "Ramdasi has brought me from the doors of death. I was about to commit suicide as the pain was unbearable. He has gifted me a new life."

 Paresh Doshi, Director of Neurosurgery at Jaslok Hospital, added, "The diagnosis of Primary Bilateral Trigeminal Neuralgia is a rare occurrence, and the successful completion of bilateral MVD at Jaslok Hospital is a commendable achievement. While the surgical procedure of Bilateral Micro Vascular Decompression is well-established, Bilateral Decompressive Surgery is uncommon."

Milind Khadke, Director of Medical Services at Jaslok Hospital, commented, "The successful treatment of Primary Bilateral Trigeminal Neuralgia with Bilateral Micro Vascular Decompression, the first in India, is a monumental achievement for Jaslok Hospital. We are proud of our team's dedication to the vigilant diagnosis of rare cases and delivering life-changing results. I am delighted to see our patient walking out pain-free and continuing the same now for months."