The trigeminal nerves found on both sides of your head are responsible for many of the feelings and sensations throughout your face. In particular, your trigeminal nerves are connected with your mouth and involved in the sensations you feel while chewing and swallowing food. In addition, your trigeminal nerve terminates in the area of your skull where many migraines originate.
Along the way, this nerve channel goes through your cheeks and can cause horrific flares of pain through that area. As with nerve blocks used to reduce pain throughout other areas of your body, trigeminal nerve blocks are meant to be a semi-permanent reaction to your current trigeminal neuralgia pain.
Unfortunately, nerve blocks do not help all patients. Your trigeminal nerve block may reduce or obliterate the pain that you feel for a small amount of time, but not throughout a long-lasting period. Like any medical intervention, it’s important to allow your nerve block enough time to work before declaring it a failed procedure.
Keep in mind that the pain caused by the needle that delivers the pain-reducing steroid medication can enhance your trigeminal pain levels for a few days after the procedure. Some people may even need to undergo a series of injections to achieve true relief.
Unfortunately, after a trigeminal nerve block, you may still find that your level of pain is at unacceptable levels. It may still even be debilitating. If this is the case, you need to consult with your neurosurgeon to see what other types of surgical interventions may give you better relief than your trigeminal nerve block.
Seeking a New Course of Treatment
Trigeminal neuralgia is a complex disorder where no one certain type of treatment helps every single patient. That fact alone can be very frustrating for you to absorb as a patient, and even more so because of the high level of pain you’ve likely been experiencing.
Frustrating though it may be, it is important to set proper expectations with your doctor. For instance, you should know that no results are guaranteed and that multiple options may need to be explored before you find relief.
Treatment Options After Trigeminal Nerve Block Failure
Fortunately, neurosurgeons have a good-sized arsenal when it comes to the treatment of trigeminal neuralgia pain. You and your surgeon may discuss:
- Microvascular decompression – This procedure relieves impingement by placing a surgical sponge between the trigeminal nerve and the blood vessel pressing into it.
- Gamma Knife Radiosurgery – This concentrates multiple beams of radiation on the portion of the trigeminal nerve that is sending pain signals.
- Percutaneous rhizotomy – This uses a special needle to deliver heat against the portion of malfunctioning nerve in order to disable it from causing pain.
- Pain stimulator placement – This sends signals down the trigeminal nerve channel that interrupts pain using customized patterns and signal strength.
The specific circumstances of your trigeminal neuralgia will determine which procedure should be pursued first. For instance, if it is clear that you have nerve impingement, microvascular decompression may be the best option. However, if you are experiencing a more complex condition such as bilateral trigeminal neuralgia, your neurosurgeon may recommend that you pursue a different type of treatment first.
Developing a Relationship With Your Neurosurgeon
It’s important to develop a good relationship with your neurosurgeon. After all, you are trusting them to complete an extremely intricate procedure on you. As you work with your newly chosen surgeon, here are a few tips for developing that relationship.
- Be honest with your neurosurgeon about your level of pain.
- Share your entire medical and surgical history with your surgeon. Your past experiences may influence which procedure you pursue and may help you anticipate any outcomes.
- Work closely with the medical business office staff to check on your benefits coverage.
- Design an entire protocol of treatment that includes any imaging or tests that need to be done, pre-surgical considerations, day-of expectations, in-patient versus out-patient determinations and post-surgical follow-ups.
- Follow your physician’s advice on things to do before and after your surgical procedure to optimize results, and ask for guidance if you do not understand some of the recommendations.
Most importantly, never hesitate to bring any and all questions you have with you to your appointments. Your surgeon will want to work closely with you to ensure that your concerns and anxieties are minimized prior to your designated procedure.
In addition, while you may spend time online researching your procedure, the information your doctor gives you will be far more specific to your exact situation. Once you’ve decided to try surgical interventions, maintaining a clear flow of communication with your doctor will help you understand everything going on. By maintaining realistic expectations, you will set yourself up for the best chance of success.
