Endoscopic Vascular Decompression vs MVD

I am seeing a neurosurgeon in Charlotte next week regarding the severe nerve pain under my bottom right teeth that I have had for 3 years. This will be the 9th doctor I have seen. I also have an appt at Duke lined up with Dr. Fukushima for March 26th. I know the dr at Duke specializes in Endoscopic technique. I am unsure if Charlotte dr offers this. I may not even be a candidate for either but am trying to get educated and know all the correct questions to ask. This pain is greatly altering my quality of life the past few months. Trileptal is helping me to function, but I am by no means pain free. Does anyone have opinions/info on the Endoscopic Vascular Decompression technique vs regular MVD with the larger incision, or have any experience with Dr. Fukushima? From my research online he sounds like my better option and appears to have vast experience with TN. Thoughts?

Before going to Dr Carson at Johns Hopkins in Baltimore, Maryland, I called the Trigeminal Neuralgia Association for info on docs that did the MVD. I think they are at endthepain.org now. Also, there may info on this site, just do a search here for the docs name(s) and then the procedure you want to know about. If you’d like to know more about my experience, you can read my page or msg me. I’ll be praying for wisdom in your decision for a procedure. This is such a hard road, and to make decisions under the duress of pain is really tough! Keep us posted on your progress!

There is a patient recommendations list under the "Face Pain Info" tab on the menu above. If a patient has reported a good experience with a physician by name, there will be a name in the listing.

Regarding Endoscopic examination in MVD: Yes, the incision is somewhat smaller. But the point of the exercise is to be able to more thoroughly examine the inner surfaces of the trigeminal nerve, looking for compressing veins or arteries. Generally speaking, any technique that reduces the amount of physical manipulation that the surgeon must do with the nerve, is a plus in better pain control outcomes over time.

Regards and best,


My wife, Kathi, has a surgical consultation this coming Thursday at the Skull Base Institute in Los Angeles, CA. We hope the doctors there can answer whether she is a good candidate for this procedure. The radiologist that reviewed her MRI and MRA did not make mention as to whether a potential MVC was present or not.

I Love my wife completely and it pains me to see her suffer. So far she has had dramatic side affects with the common medications used to manage TN. We hope and pray the EMD will be our answer to prayers.

Has anyone on this site had or known someone who has had EMD? Has anybody seen or know anything about Dr. Hrayr Shahinian? He is the director for the Skull Base Institute in Los Angeles. We are interested in hearing other people's experiences and opinions.

Hrayr K. Shahinian


I'm very sorry your wife is suffering with TN. Where is her pain? I saw Dr. Fukushima at Duke last week. I will have the EVD on May 11th. I am very nervous about it, but feel it is the right decision. Dr. Fukashima has performed this surgery 2500 times and has a high cure rate for getting rid of the pain. The "dime" sized hole in my head sounds much more desirable than traditional MVD. I have corresponded with someone who had this surgery and said her recovery was very managable. Dr. Fukushima indicated to me that MRI is often not reliable at all for diagnosing TN. I had learned this through my own research as well. He was also very much against the Gamma Knife procedure as it is so damaging to the nerve and recurrence rate is very high. I suggest taking a list of questions with you to the appointment. I can never remember everything I want to ask when I am there. Best of luck to you and your wife.