Receiving a definitive diagnosis for trigeminal nerve pain (also known as Trigeminal Neuralgia or TGN) can be both a blessing and a curse. On the one hand, you now know exactly why you’ve been experiencing extreme pain and discomfort, but on the other, you need to determine how to best approach treatment and relief.
Non-Surgical Treatment Options for Trigeminal Nerve Pain
It’s possible you’re reading this because you’ve already tried some of the first options for your trigeminal nerve pain treatment and found very little or no relief. These treatments can include drugs such as antispasmodics and anticonvulsants, or botox injections. Unfortunately, many people don’t find adequate or permanent relief from the most common treatments, outlined below in the order in which they’re typically administered.
Pharmaceuticals. Once you’ve received a diagnosis for trigeminal nerve pain, your specialist will likely recommend trying drugs first to help alleviate the painful symptoms of your TGN, including anticonvulsants and antispasmodics such as Tegretol or Trileptal. While some sufferers do find relief through anticonvulsants and antispasmodics, it’s not uncommon for patients to have breakthrough symptoms or not respond at all. The next course of trigeminal nerve pain treatment typically involves nerve blocking injections.
Botox Injections. If drugs don’t prove effective for a trigeminal nerve pain sufferer, many will try Botox injections. These injections cause paralysis of the trigeminal nerve, alleviating its pain response and the associated nerve signals. There are some major drawbacks to using botulinum toxin injections, including facial numbness or tingling, the need for regular injections to maintain its effectiveness, or the possibility that they won’t work well and result in breakthrough pain symptoms.
When Other Options Don’t Work
Many people will find themselves faced with having to seek out surgical intervention for their TGN when other treatments fail to bring adequate relief. Most doctors will recommend trying the more non-invasive options first and save surgery in the event that drugs or injections don’t work.
It may sound a bit scary, but the surgical procedures used to treat trigeminal nerve pain are advanced, safe, and, best of all, often permanent. Most people are fully recovered from the surgery itself in under four weeks.
In the case of surgeries such as microvascular decompression (MVD), results can be nearly instant, and often by the time the discomfort from the surgery itself has subsided, there are no trigeminal nerve pain symptoms present anymore. Other surgeries and procedures such as Gamma Knife Radiosurgery and percutaneous rhizotomy can take a little longer but typically render the same end result — reduced or no symptoms.
Surgical Options for Trigeminal Nerve Pain Treatment
Once you’ve made the decision with your facial pain specialist to seek out surgical intervention, it will be of the utmost importance for you to fully familiarize yourself with the surgery your specialist and surgeon deem most appropriate for your individual case and set of circumstances. Below are the most widely used surgical options and the basic premise of each.
Microvascular Decompression
Microvascular decompression (MVD) is the most regularly performed surgery for trigeminal nerve pain treatment. It is modestly invasive, allowing for a fairly short recovery and the ability to resume your normal activities not too long after surgery. The method involves the surgeon isolating the trigeminal nerve and the blood vessel that is causing the irritation. Once they’ve been positively identified, the surgeon gently lifts the vessel and places a very small Teflon sponge between the vessel and nerve, creating a buffer between the two.
The greatest benefit of this surgery is that no sensation whatsoever is lost and pain relief from the trigeminal nerve irritation is almost instant. Certain health criteria must be met to undergo MVD, including a high-resolution MRI (FIESTA MRI sequence) that reveals the nerve being compressed by a vessel.
Gamma Knife Radiosurgery
Gamma Knife Radiosurgery (GKRS) is the next best option for surgical intervention if it is determined that microvascular decompression is not the best trigeminal nerve pain treatment option for you and your individual case and needs. This is a non-invasive procedure using tiny, hyper focused, high-power energy beams that converge at one point, allowing for incredible accuracy. The offending area(s) of the nerve are targeted to destroy portions of the nerve tissue that are causing the pain and discomfort.
Since there is no invasive component, Gamma Knife Radiosurgery is an excellent option for those with health issues that may preclude them from undergoing traditional surgery. The recovery time is also negligible. The one downside is the potential for loss of sensation due to the destruction of the nerve tissue.
Percutaneous rhizotomy and pain stimulator placement are the last two options when looking at the range of surgical options available for trigeminal nerve pain treatment.
Percutaneous Rhizotomy
Percutaneous rhizotomy involves using either radiosurgery or chemical means to damage portions of the nerve and alleviate the pain. Obviously, the nerve may repair itself and require additional procedures to be performed. This is typically an outpatient procedure.
Pain Stimulator Placement
Pain stimulator placement is somewhat more invasive but is also a valid trigeminal nerve pain treatment option if nothing else is deemed effective. This procedure involves placing tiny electrodes under the skin, pinpointing the nerve. Mild electrical stimuli is relayed to these electrodes via an external stimulator. These electrical waves interrupt pain signals, thus allowing the sufferer to stop the nerve from misfiring.
Only you and your surgeon can determine the best course of action (surgically speaking) when it comes to which procedure will be of the greatest benefit and least risk to you. Starting on the path to relief from the pain and uncertainty created by your trigeminal nerve pain is only a consultation away.
