If you have facial pain due to trigeminal neuralgia, you may benefit from a variety of different treatments to manage your pain. Initially, your doctor may prescribe medication to help decrease your pain or muscle spasm. Unfortunately, medication for trigeminal neuralgia tends to lose its effectiveness over time, and your doctor may need to frequently change the dosage for you to get the maximum benefit.
Surgery is considered the definitive treatment for persistent trigeminal neuralgia. There are many different surgical options for trigeminal neuralgia depending on your health history and the cause of your condition.
Trigeminal neuralgia is caused by irritation of the trigeminal nerve, your 5th cranial nerve. The nerve conducts signals for pain from your face to your brain, and a portion of it helps to move the muscles in your jaw. When your trigeminal nerve becomes irritated, a sharp, shooting facial pains may result.
So what would cause your trigeminal nerve to become irritated? Occasionally, but rarely, a serious problem like a stroke, brain tumor or multiple sclerosis may cause irritation of your trigeminal nerve. More commonly, your trigeminal nerve becomes irritated by being compressed by nearby vascular structures near your brain stem. Surgery for this condition is done to relieve this pressure.
Surgery for Trigeminal Neuralgia
There are different surgical procedures to treat your trigeminal neuralgia. The most common are:
- Microvascular decompression surgery
- Gamma Knife Radiosurgery
- Percutaneous rhizotomy
- Pain stimulator placement
Each surgery carries its own set of risks and benefits, and understanding each surgery and the recovery process after surgery is an important part of your decision-making process when managing your trigeminal neuralgia. Working with a trusted neurosurgeon can help you achieve a positive outcome with your surgery.
Microvascular Decompression Surgery Recovery
The gold standard surgery for trigeminal neuralgia is called microvascular decompression. During this procedure, your trigeminal nerve is visualized by having your surgeon make a small incision behind your ear and by removing a tiny portion of your skull.
Once your trigeminal nerve is exposed, a small Teflon pad is inserted between the nerve and its neighboring artery. This helps to take pressure off of your trigeminal nerve to help relieve your facial pain.
Benefits of microvascular decompression include:
- A rapid relief of pain
- A highly successful in offering long-term pain relief
- A minimal need for medication after the procedure
Since microvascular decompression is a type of brain surgery, you will be required to remain in the hospital for a few days following the procedure. Immediately after your surgery, you will be brought to the intensive care unit for close monitoring for 24 hours. After that time, you will be brought to a standard hospital room and encouraged to slowly increase your activity level in the hospital. Once you are moving around normally, your doctor will check on you and you will likely be discharged home to continue your recovery.
During the first week after microvascular decompression surgery, you will be expected to slowly and gradually increase your activity level, but you should avoid any strenuous activity or heavy lifting. At the end of the first week, you will visit your doctor who will check your incision and monitor your symptoms. Most patients have virtually no facial pain at this point.
Over the coming weeks after microvascular decompression, you can gradually get back to normal work and recreational activity. Most people are back to their active lifestyle one month after the procedure.
Gamma Knife Radiosurgery Recovery
During Gamma Knife Radiosurgery for trigeminal neuralgia, numerous beams of radiation are focused on your trigeminal nerve. The radiation slightly damages your nerve, decreasing painful signals traveling through it.
Although Gamma Knife Radiosurgery is considered brain surgery, no incision is made. Therefore, you will likely be discharged home within hours of your procedure. You can expect to feel tired for a few days after the procedure, but you can quickly get back to your normal activity level.
You can expect to follow up with your doctor a few weeks after Gamma Knife Radiosurgery. Your surgeon can examine you and monitor your facial pain. Trigeminal neuralgia typically takes a few weeks to subside after Gamma Knife Radiosurgery.
Percutaneous Rhizotomy Recovery Process
During percutaneous rhizotomy, your neurosurgeon uses a small needle to place an electrode near your trigeminal nerve. An electrical charge is then used to cauterize your trigeminal nerve, slightly damaging it to decrease painful transmissions through it.
After percutaneous rhizotomy, you can expect a little soreness where the needle was inserted, and you will likely be sent home soon after the procedure. Your trigeminal neuralgia symptoms will slowly subside over a few weeks, and you can get back to your normal activities within a few days of your percutaneous rhizotomy procedure.
Pain Stimulator Implant Recovery
Pain stimulator placement involves using electrical stimulation to block painful signals in your trigeminal nerve. The procedure takes place in two stages. First, a temporary trial electrode is threaded to an area near your trigeminal nerve. A small control device is used to provide an electrical signal, blocking painful stimuli.
If the temporary electrode proves to be effective for pain relief, a permanent electrode will be inserted. This is then attached to a subcutaneous battery, and a handheld wireless control device can be used to adjust the amount of stimulation provided to your trigeminal nerve.
Most patients feel rapid relief of symptoms with pain stimulator placement, and you can expect to get back to normal activity within a week of the procedure. You will need to follow up with your doctor on a regular basis to ensure the device is working properly and is providing you with adequate relief of you trigeminal neuralgia.
Find the Best Neurosurgeon for Trigeminal Neuralgia Treatment
If you have trigeminal neuralgia, you should find a trusted neurosurgeon to work with. Your doctor should take the time to listen to your questions about trigeminal neuralgia surgery, and he or she should offer you alternatives to treatment. Your neurosurgeon’s staff should treat you with respect and courtesy as well.
Your doctor should feel like a trusted ally in treating your trigeminal neuralgia. You and your doctor should work in a therapeutic alliance to find the best treatmenst for your facial pain.
If you have trigeminal neuralgia, you should take a moment to learn about the various treatments available to you. By working with a top-rated NJ neurosurgeon, you can know what to expect from surgery and from your recovery. That way, you can focus on your return to your normal lifestyle with minimal or no facial pain or trigeminal neuralgia symptoms.
