Neurological Conditions and Their Treatment Options – Peripheral Nerves

Peripheral Nerves surgery and treatments California Neurosurgical Institute



Chiari decompression


Chiari malformations are congenital variations of the back of the brain which can cause head aches and other symptoms that respond poorly to medications. Decompression surgery can relieve this condition.


Microvascular decompression for trigeminal neuralgia


Trigeminal neuralgia causes very severe pain to the face from an artery pressing a nerve in the brain. Microvascular decompression is a brain operation using a microscope to separate the blood vessel from the nerve, often with dramatic improvement.


Microvascular decompression for hemifacial spasm


The cause of hemifacial spasm is similar to trigeminal neuralgia with a blood vessel compressing a nerve. The surgery separates the blood vessel from the nerve.


Microvascular decompression for Glossopharyngeal neuralgia


Glossopharyngeal neuralgia is similar in cause to the above two conditions.
CNI surgeons are specialists in the treatment of these conditions.

A Brief Introduction to Peripheral Nerve Surgery

Neurologic surgeons perform procedures to the nerves outside the spine. Conditions requiring treatments include trauma and tumors, but by far the most common indications are pressure from adjacent anatomy.

Compression of the median nerve in the wrist, known as carpal tunnel syndrome, is the most common nerve condition requiring surgery. The condition can produce wrist discomfort involving the first three fingers which may interfere with sleep.

The nerve is compressed under the transverse carpal ligament near the wrist. Older procedures to divide the ligament required long incisions in the palm which were tender healing and required a long period of limited hand activity.

Minimally invasive neurologic surgery employing the microscope has made the procedure much smaller with faster recovery.

The next most common procedure is decompression of the ulnar nerve in the elbow for tardy ulnar palsy, also known as cubital tunnel syndrome.

This condition can produce tenderness to the elbow with numbness and discomfort to the fourth and fifth fingers. In cases that do not respond to conservative measures, the condition can be treated with a simple outpatient procedure.
Recent research shows that the simple decompression operation is more successful than bigger more complicated procedures.

Less often nerve conditions treated by decompression include the lateral femoral cutaneous nerve which produces a discomfort to the outside of the thigh known as meralgia paresthetica.

Another condition that can cause discomfort to the inside and bottom of the foot caused by compression of the tibial nerve in the tarsal tunnel known a tarsal tunnel syndrome.

Again as for most of these conditions, they can be successfully relieved by simple outpatient surgery with very low risk.


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