Trigeminal neuralgia is a disorder in which your trigeminal nerve, or the nerve that carries sensation from your face to your brain, is chronically irritated.
In its early stages, trigeminal neuralgia may cause you to experience short, mild episodes of facial pain. As the condition progresses, however, the pain in your face can last longer and become more severe. Possible symptoms include:
Trigeminal neuralgia pain, which radiates along the nerve in a typical pattern, is usually described as a shooting pain that may feel like an electric shock. The pain is sometimes so severe that patients try to avoid any touch to their face.
Although there are a wide variety of potential underlying causes of trigeminal neuralgia, the pain itself is a sign that the trigeminal nerve’s function has somehow been disrupted. This is often the result of a blood vessel that’s too close to the nerve’s root at the base of your brain, which can irritate the nerve and cause pain sensations in your face.
Conditions that can cause this abnormal, irritating contact include:
Trigeminal neuralgia treatment may be initiated by your primary care doctor or by a neurologist. For many patients, prescription medications such as carbamazepine, gabapentin, or pregabalin provide sufficient pain relief and make the condition manageable.
If the effects of these medications begin to fade with time, however, or if the medications themselves cause side effects, surgery is often the next viable option.
Surgical options include glycerol injection rhizotomy, which involves the injection of sterile glycerol near the root of the trigeminal nerve in order to block pain signals, as well as radiofrequency thermal lesioning rhizotomy and radiosurgery.
Microvascular decompression is the definitive surgical treatment for trigeminal neuralgia. During this procedure, Dr. Melamed identifies the vessel that’s irritating the nerve and moves the cause of irritation away.
Microvascular decompression has been shown to be a very safe and effective way to address trigeminal neuralgia. In fact, the procedure actually cures some patients.
At Advanced Brain & Spine, Dr. Melamed uses endoscopic, minimally invasive surgical techniques to perform microvascular decompression. The endoscope allows him to see all the way around the nerve. This is crucial because the vessel that’s irritating the nerve is often on the other side of the nerve, out of the direct line of sight.