Trigeminal Neuralgia Treatments

What Is Trigeminal Neuralgia?

Trigeminal neuralgia is a condition with excruciating ipsilateral (occurring on one side of the body) facial pain. These intermittent episodes of pain, usually only on the left or the right side of the face, have been described by patients as:

  • stabbing
  • burning
  • shooting
  • and electric-shock like.

These sudden and intense episodes of severe face pain stem from the fifth (trigeminal) cranial nerve. This nerve has three branches:

  • the ophthalmic nerve, corresponding to the forehead, upper eyelids, eyebrow and upper part of the nose
  • the maxillary nerve, providing sensation to the upper mouth, lower nose, cheek and under the eye
  • the mandibular nerve, correlates to the lower mouth, jaw and up to the ear

Non-Surgical Treatments for Trigeminal Neuralgia

Anti-seizure medication that works to disrupt the abnormal electrical currents that cause epileptic seizures can also interfere with the pain signals from the trigeminal nerve to the brain and provide pain relief.

Advanced Trigeminal Neuralgia Treatments at NSPC

We provide support and information for those with trigeminal neuralgia and related facial pain, their friends and family, and caretakers. Neurological Surgery, P.C. (NSPC) regularly hosts the Trigeminal Neuralgia Support Group located here in New York.

In our New York metro region practice, NSPC has doctors who specialize in trigeminal neuralgia surgery. Our premier medical facilities and experienced neurologists and pain management specialists can treat your facial pain with a number of advanced surgical procedures.

Microvascular Decompression Surgery is a microsurgical procedure that treats TN by removing the pressure on the nerve. One of our board-certified skilled neurosurgeons creates a small hole in the skull, behind the ear. This craniotomy provides a window for the surgeon to open up the dura (cerebral membrane) and carefully retract the cerebellum. The artery or vein pushing on the nerve can then be delicately moved aside and a cushion placed between it and the nerve. With the nerve decompressed, the pain signals should no longer occur.

Other techniques seek to disrupt the pain signal by damaging the trigeminal nerve or nerve root. These are less invasive procedures than the microvascular decompression surgery, but are considered palliative (pain relieving) rather than curative.

Rhizotomy Treatments relieve trigeminal nerve pain by destroying the root (rhizome) of the nerve. Most patients can feel the results before they leave for home.

  • Glycerol Rhizotomy is a percutaneous (through the skin) technique that uses a needle in the cheek to deliver the glycerol solution to the nerve clusters. This outpatient procedure has a short recovery time and can be repeated if needed.
  • Radiofrequency Rhizotomy is also an outpatient procedure. This technique employs an electrode to deliver a current to the nerve; thus injuring the nerve to prevent nerve signals from traveling to the brain.

Balloon Compression involves a catheter (tiny flexible tube) with a balloon inserted into the place where the trigeminal nerve travels through the skull. The neurosurgeon inflates the balloon to compress the nerve ganglion. The balloon is then deflated and removed along with the catheter.

Peripheral Nerve Stimulation involves implanting a small electrode near the nerve pathways. The electrical current stimulates non-pain messages to the brain, bringing pain relief.

Gamma Knife Radiosurgery is another noninvasive surgery technique that damages the trigeminal nerve. Using state-of-the-art technology, the neuroradiologist delivers gamma rays (a type of radiation) to the nerve or nerve root. The pain relief can take a bit longer, but for patients who do not want a craniotomy (cranium surgery) and prefer a less invasive technique, Gamma Knife may be your best treatment option.

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