If you have trigeminal neuralgia, you understand how the symptoms can limit your ability to concentrate on work, family or recreational activities. Your facial pain can range from mild to severe, and it may be present intermittently or constantly.
Trigeminal neuralgia is a condition where there is irritation of the 5th cranial nerve, the trigeminal nerve. When this structure becomes irritated or compressed, pain can result on one side of your face. The pain may feel like sharp, shooting sensations or like a dull burning sensation.
Symptoms of trigeminal neuralgia may include:
- Pain on one side of your face
- Tingling or burning in your jaw, cheek or eye
- Ear pain
- Pain in your teeth
- Electric-like shots of pain through one side of your face
If you have any of these symptoms, see your doctor to get an accurate diagnosis of your condition and to start on the correct treatment for you.
Diagnosis of trigeminal neuralgia can be done by your doctor or by a facial pain specialist. There is no diagnostic test for trigeminal neuralgia; your doctor may order tests like an MRI or CT scan to rule in or out various causes of your facial pain. Your trigeminal nerve pain may be caused by a brain tumor, stroke or multiple sclerosis, although these are rare.
More often your trigeminal neuralgia is caused by the irritation of the trigeminal nerve being compressed by its neighboring artery or vein. When this happens, the myelin sheath that covers the nerve may wear away, causing pain and symptoms of trigeminal neuralgia.
Trigeminal Neuralgia Treatment
If you have trigeminal neuralgia, there are different treatments available to help you manage your symptoms. Initially, your doctor may control your facial pain by prescribing various medications. These medications help to decrease nerve transmissions of painful stimuli or help to decrease muscular spasm.
The most definitive treatment for trigeminal neuralgia is surgery. There are different types of surgery available for your facial pain, and your neurosurgeon will help determine the best one based on the cause of your trigeminal neuralgia and your medical history.
You need to take time to learn about the various treatments available for trigeminal neuralgia and the relative cost and recovery timeframe of each treatment. That way you can make an informed decision about your care for your trigeminal nerve pain.
Medication for Trigeminal Neuralgia
When first diagnosed with trigeminal neuralgia, your doctor will likely prescribe medication for your symptoms. Medication may include:
- Anticonvulsants
- Antispasmodics
- Botox injections
Medication is typically used to treat pain and muscular spasm that go along with trigeminal neuralgia. Long term use of medication has the downside of your body developing a tolerance for the medicine, and thus your doctor will likely need to increase your medication dosage as your continue to take it.
Medication for trigeminal neuralgia has certain side effects. These may include dizziness, confusion, drowsiness and nausea. Botox injections are largely considered experimental, and therefore may not be offered by your doctor.
The cost associated with medication may vary based upon your insurance coverage and the type of medication you take. You should also factor in the cost of repeated doctor visits which may be necessary to monitor your response to medication and to make dosage adjustments.
Surgery for Trigeminal Neuralgia
If medication use for your trigeminal nerve pain fails to give you adequate relief of symptoms, or gives you significant side effects, you may need to visit with a neurosurgeon to discuss surgical options for your facial pain. Different surgical procedures may be performed, and each one has a slightly different recovery timeline. Also, the cost associated with each procedure may vary. Understanding the types of surgery available can help you choose the best procedure for you.
Microvascular Decompression Surgery
During microvascular decompression surgery, your neurosurgeon will make a tiny incision behind your ear and remove a small portion of your skull. Then, your trigeminal nerve will be visualized and a small Teflon pad will be inserted between your nerve and its neighboring artery. This helps to relieve pressure off your nerve, relieving your facial pain.
Since microvascular decompression is open brain surgery, you will be required to spend a couple of days in the hospital to ensure you recover properly. Once discharged home, you can slowly increase your activity level.
Most patients enjoy rapid abatement of their trigeminal neuralgia symptoms after microvascular decompression. Although not guaranteed, many experience full resolution of their facial pain symptoms.
Microvascular decompression surgery can be quite expensive, since you will be staying in the hospital under constant observation. Many different healthcare professionals will be involved in your care, and you may be required to cover the out-of-pocket cost of these specialists. Missed time at work may also factor into your total personal cost of microvascular decompression surgery.
Finding a neurosurgeon who has an insurance specialist on hand can be helpful when considering microvascular decompression surgery. This person can help you navigate the insurance maze and help you understand your personal financial responsibilities when considering microvascular decompression.
Gamma Knife Radiosurgery
During Gamma Knife Radiosurgery, your doctor will use a specialized instrument to focus several beams of radiation at your trigeminal nerve. This radiation slightly damages the nerve, decreasing painful transmissions through it.
Although considered brain surgery, no incision is made, and most patients can go home the same day as the procedure. Your symptoms will slowly resolve after Gamma Knife Radiosurgery, and if they return sometime in the future, you are able to have the procedure again.
There are some costs associated with Gamma Knife Radiosurgery. These may include:
- Surgical center fees
- Specialist fees
- Costs of intraoperative diagnostic testing
You may also face the cost of lost time at work, but this time is typically minimal after Gamma Knife Radiosurgery, as a most patients feel quite well after the procedure.
Percutaneous Rhizotomy
Percutaneous rhizotomy involves your surgeon using a small needle to thread an electrode near your trigeminal nerve. Then, a small current is used to cauterize the nerve, decreasing painful transmissions.
Recovery after rhizotomy is quite simple, and many patients are back to their normal activity level within a day or so of the procedure. Symptoms should slowly resolve over a few weeks after percutaneous rhizotomy.
Personal costs associated with percutaneous rhizotomy are minimal and may only include fees to your surgeon. Again, working with an insurance specialist can be helpful.
Pain Stimulator Placement
If your trigeminal neuralgia symptoms persist, you may benefit from a pain stimulator implant. During this procedure, a small electrical stimulation wire is threaded to an area near your trigeminal nerve. Electricity then stimulates your nerves, decreasing your pain sensations in your face. You can control the electrical current with a handheld device.
The cost of a pain stimulator implant is similar to rhizotomy, but you may need to visit your doctor regularly for adjustments to the stimulator unit and to check on your pain control.
Dealing with trigeminal neuralgia can be difficult to do, and understanding the treatments available to you can help you find the best neurosurgeon for your condition. By working with a top-rated NJ neurosurgeon, you can maximize your chances of a successful outcome with your trigeminal neuralgia treatment.
