The facial pain caused by trigeminal neuralgia (TN) can create misery and profoundly affect your quality of life. Fortunately, help is available through several noninvasive or minimally invasive neurosurgical techniques, particularly Gamma Knife Radiosurgery. The discussion below will acquaint you with the disorder, as well as provide an overview of the method by which the treatment works, its benefits and when it should be considered.
What Is Trigeminal Neuralgia?
A debilitating affliction, trigeminal neuralgia affects the nerve that carries sensation from your face to your brain. Trigeminal neuralgia can be caused by multiple sclerosis, pressure from a blood vessel or an injury to the nerve. In rare cases, a tangle of arteries and veins called an arteriovenous formation or a tumor can compress the nerve and produce symptoms. If you have this condition, even the mild stimulation of your face associated with everyday activities such as applying makeup can produce excruciating pain. Although people over 50 are most commonly affected by this disorder, it can occur at any age.
How Does Gamma Knife Radiosurgery Work for Trigeminal Neuralgia?
In the treatment, multiple beams of radiation target the trigeminal nerve at the point where it enters the brain stem. Consequently, the abnormal portions of the nerve are damaged and the transmission of pain is decreased. In effect, the intervention scrambles the pain pathways, but it is possible that the pain will return at a later time. If this happens, the intervention can be repeated safely after a sufficient waiting period.
What Are the Benefits of Gamma Knife Radiosurgery?
The key advantage of Gamma Knife Radiosurgery is its noninvasive aspect. Since the procedure requires no incision into the skull, it doesn’t involve the potential risks of traditional surgery like infections, bleeding and adverse reactions to general anesthesia. The treatment is done on an outpatient basis (you go home on the same day), a benefit that eliminates the need for post-surgical hospitalization and recovery. You will experience very little discomfort, as opposed to the incisional pain you would have after an operation. Side effects are usually mild, and you can often return to your regular activities within 48 hours.
Because Gamma Knife Radiosurgery isn’t actually surgery, it’s a viable choice for patients whose age or medical condition would make an operation “higher risk”. The procedure is generally safe for the elderly or patients with significant health issues. It is also useful for those whose disorder lies in an inaccessible part of the brain.
Most importantly, a 1998 study published in JAMA Neurology found approximately 80 percent of patients undergoing Gamma Knife Radiosurgery receive significant pain reduction. Some cases get relief after four to six weeks, while others require several months to develop the full response. For patients whose pain is completely eradicated, the recurrence rate is low.
In remediating trigeminal neuralgia, the goal of doctors is to manage pain without the loss of normal facial sensation. Since the treatment involves a low risk of tingling, prickling and sensory loss, it is a strong contender when weighing options. An evaluation of the potential benefits and potential risks makes it the logical choice for many.
When Should You Consider the Procedure?
If you have been diagnosed with trigeminal neuralgia by a neurologist, Gamma Knife Radiosurgery is not your first option. Before considering the treatment, your doctor will recommend the medications of Tegretol or Trileptal. Although they were originally developed for the remediation of seizures, they can effectively treat nerve pain. Unlike narcotics, which are inappropriate for trigeminal neuralgia, these pain drugs are not addictive.
While medical management is the answer for some, it proves unsuccessful for others because of poor tolerance or an unsatisfactory response to the trigeminal neuralgia drugs. If you experience side effects that persist after changing medications, such as fatigue, drowsiness or a cloudy feeling, you should see a neurosurgeon. In addition, if your severe pain is not relieved by higher doses of these drugs, it is time to try a non-drug intervention.
At this point, your doctor should order a high-resolution magnetic resonance imaging test to see if your trigeminal neuralgia is caused by a blood vessel compression on your trigeminal nerve. If compression of your nerve is found and if you are otherwise healthy, the best treatment approach is often microvascular decompression (MVD) surgery, a procedure that consists of the insertion of a Teflon cushion between the nerve and the structure causing the compression. However, if MVD surgery isn’t right for you, the best treatment option after medical failure is Gamma Knife Radiosurgery.
Gamma Knife Radiosurgery offers hope to people who suffer from severe trigeminal neuralgia pain that can’t be remedied with medications. Since the treatment is successful in the majority of patients and it involves relatively few health risks, it is frequently recommended by neurosurgeons for patients who are suitable candidates.
