Who is a good candidate for MVD, and what are the contraindications?
Ideal candidates are patients with classic trigeminal neuralgia, hemifacial spasm, or glossopharyngeal neuralgia that has not responded to medication or other less invasive treatments. A clear diagnosis of neurovascular compression on high-resolution MRI is essential. Contraindications include severe coagulopathy, active infection, advanced age with significant comorbidities, or patients who cannot tolerate general anesthesia. Those with atypical facial pain or multiple sclerosis-related neuralgia are generally not good candidates, as outcomes are less predictable.