Also referred to as tic douloureux, trigeminal neuralgia causes intense, electric shock-like and stabbing pain in the lower face and jaw.
It occurs as a result of irritation to the trigeminal nerve. Surgery is often considered because medications often fail to provide relief. In most cases, only one side of the face is affected.
It is estimated that approximately 12 per 100,000 people are affected by this condition each year.
Microvascular Decompression
This surgery is done to remove or relocate blood vessels that are pressing on the trigeminal nerve root. This is done to alleviate any nerve malfunctioning. During the surgery, the doctor makes an incision behind the ear on the affected side of the body. A small hole is made into the skull. Through this hole, the doctor moves the offending artery and puts a soft cushion between the artery and nerve. If a vein is pressing on the nerve, it might be removed.
This surgery can reduce or eliminate pain in most cases. However, there is always a risk that the pain can recur in the future.
Brain Stereotactic Radiosurgery
This surgery involves a focused dose of radiation that is directed onto the trigeminal nerve root. The root gets destroyed by the radiation to eliminate or reduce pain. Relief is not immediate with this procedure. The discomfort usually decreases over the course of up to a month.
Balloon Compression
This procedure involves the use of a catheter and a balloon. A hollow needle is inserted into the face and guided to the trigeminal nerve. A catheter is threaded through the needle to the proper area of the trigeminal nerve. There is a balloon located on the catheter. Once the balloon is placed properly, it is inflated to put pressure on the nerve. This damages the nerve to block pain signals.
Most people experience relief from their pain with this procedure. However, the pain may recur in the future. After this procedure, it is common to have some transient facial numbness. The severity of the numbness varies.
Radiofrequency Thermal Lesioning
Before this procedure, patients receive sedation. A hollow needle is inserted into the space where the nerve goes through a skull base opening. Once in position, the doctor inserts an electrode via the needle and an electric current is applied. Patients are asked where and when they feel tingling. Once they are returned to sedation, the nerve fibers are damaged using the heated electrode to create a lesion to eliminate the pain.
Glycerol Injection
This procedure involves putting a needle into an opening located at the skull’s base via the face. The needle is directed into the trigeminal cistern. This is a small sac that surrounds the ganglion of the trigeminal nerve. It contains spinal fluid. Sterile glycerol is injected into this space to damage the nerve so that pain signals are blocked.
Since there are several surgical options, having a general understanding of each type can help people to make the right decision for them. Patients should work with their doctor to make the best choice.