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Trigeminal Neuralgia
Trigeminal neuralgia—commonly called tic douloureux or just tic—is a chronic pain condition that affects the facial nerves. trigeminal neuralgia pain is caused by compression of the trigeminal nerve, which carries signals from the face to the brain. This pain most frequently involves the lower lip and teeth or the upper lip and cheek, but it also may involve the nose and the area above the eye.
Trigeminal Neuralgia Symptoms:
The pain in trigeminal neuralgia is caused by compression of the trigeminal nerve at the brainstem by an artery or vein. Patients with trigeminal neuralgia experience facial pain that can be triggered by even mild sensations, like brushing teeth. The pain from trigeminal neuralgia may be mild and come and go, or it may progress and be a consistent, severe sensation in the face. Pain sensations are usually described by patients as:
- Constant aching pain in the face
- Burning pain that may evolve into a severe spasm
- Severe and sudden stabbing or shooting pains
- Feelings of jabbing pain, like an electric shock
Women are more likely to have trigeminal neuralgia than men, and those over 50 typically experience more trigeminal nerve pain. Trigeminal neuralgia is diagnosed based on patient history and physical exam, which includes medical imaging like MRI to rule out other conditions.
Trigeminal Neuralgia Treatment:
Medication is the first treatment option for trigeminal neuralgia. For those who do not respond to medications or whose trigeminal neuralgia worsens after medication therapy is attempted, surgical treatment may be needed. Other forms of treatment include surgery or radiosurgery.
- Microvascular decompression (MVD) is a surgical procedure used to treat trigeminal neuralgia. During MVD, a neurosurgeon uses a microscope to identify the artery compressing the trigeminal nerve. Then, a pad is placed between the artery and the trigeminal nerve to ease the trigeminal nerve pain. MVD is one of the most successful treatments for trigeminal neuralgia and can be a permanent cure.
- Radiofrequency lesioning (RFL) is a minimally invasive outpatient procedure used to treat trigeminal neuralgia. A patient is put under local anesthesia and a needle is inserted into the face. The RFL needle is heated so that it reversibly damages the nerve, producing numbness in the area. While RFL is highly effective, it is a temporary treatment. The effects usually wear off about 18 months after treatment and can be performed multiple times to lessen trigeminal nerve pain.
- Radiosurgery is another method for treating trigeminal neuralgia. During radiosurgery, very high doses of radiation are delivered to the trigeminal nerve in an outpatient procedure. It takes several weeks to months for the pain to resolve after radiosurgery. Typically, radiosurgery is only performed on patients who may not be able to have surgery or tolerate a radiofrequency lesioning procedure.
Treatment of trigeminal neuralgia will depend on the individual patient’s case. Because trigeminal neuralgia pain can vary in intensity and location, individualized treatment or surgery is required to ease trigeminal nerve pain.
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We specialize in Trigeminal Neuralgia Treatment.
At Nashville Neurosurgery Associates, we are proud to be one of the region’s leading neurosurgical centers. Dr. Mericle is a nationally recognized expert in the care and treatment of trigeminal neuralgia.
