Trigeminal Neuralgia

Facial Pain & Other Neuralgias

Trigeminal Neuralgia

Facial Pain & Other Neuralgias

What is a trigeminal neuralgia?

Trigeminal neuralgia is rare. There are approximately 15,000 new cases diagnosed each year. The trigeminal nerve provides sensation to the face and when irritated by a small pulsating blood vessel, produces the pain of this disorder. Less commonly, multiple sclerosis or a tumor can cause symptoms of trigeminal neuralgia.

Trigeminal neuralgia can be an incapacitating disorder. The pain is usually on one side of the face and is characterized by stabbing, shock like jolts in the jaw, cheek or forehead. Each episode can last from a few seconds to 2 minutes and can occur up to 100 times per day. It is more common in individuals over the age of 60. Pain episodes can occur spontaneously or be triggered by stimulation of the face or teeth (shaving, applying makeup, tooth brushing, eating, drinking, talking or even a light breeze). It is not uncommon for the symptoms of trigeminal neuralgia to be mistaken for dental pain.

How is trigeminal neuralgia diagnosed?

The diagnosis of trigeminal neuralgia is made by an experienced physician taking a detailed history and preforming a careful neurologic examination. In order to exclude underlying abnormalities such as tumor, vascular abnormalities or multiple sclerosis, your physician will order laboratory tests and imaging studies such as an MRI.

How is trigeminal neuralgia treated?

The most effective medications include the anti-seizure drugs such as carbamazepine, oxcarbazepine, Lamictal and gabapentin. The muscle relaxant Baclofen can also be effective. For patients in whom medications do not control the symptoms or when the side effects from the medications cannot be tolerated, there are interventional procedures which can effectively treat trigeminal neuralgia. These include microvascular decompression surgery, in which a small Teflon sheet is placed between the trigeminal nerve and the adjacent pulsating vessel. GAMMA Knife treatment involves the application of tightly focused radiation, in order to interrupt the ability the nerve’s ability to send a pain message.  A radiofrequency trigeminal rhizotomy involves placing a small electrode into the trigeminal nerve and applying heat to the nerve, thus inhibiting its ability to send a pain signal.

Can Interventional Headache Treatment help with the pain of trigeminal neuralgia?

If you have had a thorough neurological examination, appropriate investigative studies, have tried medications and continue to have debilitating symptoms from trigeminal neuralgia, interventional procedures may be an effective way to manage your symptoms. Radiofrequency trigeminal rhizotomy is one option which will be discussed as part of your initial consultation.

Is a consult appropriate for you?

Please call us to learn more.

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