When the cause in a vascular conflict, after an initial period of medical treatment which inevitably fails, a microvascular decompression is the best choice. If it also fails or the patient does not want surgery or is highly co morbid, then stereotactic radio surgery is a good option.
Hello colleagues, interesting discussion. From what I have read, some treatment options for trigeminal neuralgia are more widely available and affordable, while others are still limited to advanced centers.
More accessible and relatively low-cost methods include percutaneous procedures such as radiofrequency thermocoagulation and balloon compression, which can be performed in many neurosurgical settings.
On the other hand, high-cost and less accessible approaches such as Gamma Knife/CyberKnife radiosurgery, neuromodulation (motor cortex or deep brain stimulation), and focused ultrasound are available only in specialized centers and not for every patient.
In my opinion, combining classical and newer approaches depending on the patient’s condition and available resources could represent the most practical way forward.
I have not seen good results with the more easily accessible, more affordable procedures. It's a pity it needs so much talent, training - and, above all, an excellent teacher to enjoy ideal outcomes in any, especially neurosurgical intervention.