Trigeminal Neuralgia

Trigeminal neuralgia is a condition that affects the trigeminal nerve. This nerve provides sensation to the face and teeth, and when it is affected by TN, a patient can experience a shock-like pain, even with minimal stimulation, such as the brushing of teeth.

Typically, anti-seizure medications are the first step taken in the treatment of trigeminal neuralgia. A patient usually starts out taking a low dose, so it can take several weeks to determine whether or not the medication is effective. There are side-effects involved with many of these drugs, so the patient will require periodic monitoring to evaluate whether another medication would be more suitable.

Sometimes, medication is not effective in treating TN. In these cases, a surgical procedure called microvascular decompression (MVD) may be recommended. During this procedure, a small cushion is placed between the trigeminal nerve and a blood vessel to lessen the pressure on the nerve. If the neuralgia-like pain is from the pressure of a tumor, it will also be treated with surgery, and any other therapies that may be needed.

Surgical blocks are special injections aimed at permanently, or at least temporarily, blocking the affected part of the trigeminal nerve. Balloon Compression, Glycerol Injection and Radiofrequency Lesioning are types of blocking procedures that are performed through the cheek. Radiosurgery (Gamma Knife) is a relatively new procedure that uses radiation beams to treat the nerve.

Before a patient undergoes any type of treatment, he/she should evaluate the risks and benefits of each option thoroughly, and seek a second opinion if necessary.