Trigeminal somatosensory evoked potentials for intraoperative monitoring and prognostic prediction in microvascular decompression for trigeminal neuralgia: a prospective cohort study

The TSEP technique used in this study is simple to operate (only requiring puncture around the muscle groups near the puncture point), provides stable waveform results, and is convenient for intraoperative interpretation (only needing to observe changes in waveform amplitude). In addition, intraoperative monitoring of TNW2 amplitude change rate (≥60% indicates good prognosis) can provide real-time guidance during decompression and predict efficacy. The combination of hypertension, PTN duration ≥2.5 years, and TNW2 amplitude change rate <60% are independent risk factors for poor prognosis after MVD; patients with PTN who have hypertension, longer PTN duration, or TNW2 amplitude change rate <60% during microvascular decompression experience slower postoperative pain relief. The nomogram model based on TSEP waveforms, hypertension, and PTN duration has high accuracy and can individually assess recurrence risk, providing a tool for clinically identifying high-risk patients.