If you are suffering from trigeminal neuralgia (TGN), you’re not alone. It is estimated to affect between 1 in 15,000 and 20,000 people. As you know, the day-to-day struggles you face when you are battling the debilitating symptoms can take your time and enthusiasm for life.
Medication is almost always the first line of defense against the symptoms of trigeminal neuralgia. While it’s non-invasive and is easy to dispense, what if it doesn’t work? If you’re amongst this group and dealing with trigeminal neuralgia that isn’t responding to medical management, what are your options?
Luckily, surgical interventions such as microvascular decompression and pain stimulators, or non-invasive therapies such as Gamma Knife Radiosurgery are available. Many people may find trigeminal neuralgia pain relief through medications such as Tegretol, but if you’re amongst those who don’t, you have other options you can explore.
Understanding Trigeminal Neuralgia
Trigeminal neuralgia is the malfunctioning of the trigeminal nerve, one of the main nerves that provide sensation to the face. This can be caused by a blood vessel, such as a vein or artery, putting constant pressure on the nerve, damage to the myelin sheath, or a tumor or lesion growing on, or next to, the nerve. Regardless of the cause, it is a debilitating condition often likened to an intense and painful shock. The symptoms can be intermittent or occur on a daily basis, sometimes occurring multiple times per day. Due to this pain, many people are unable to partake in normal, everyday activities when contending with trigeminal neuralgia.
Non-Pharmaceutical Trigeminal Neuralgia Treatment Options
When medications don’t provide an adequate level of relief, cause unbearable side effects, or stop working after a long period of use, it is time to start looking into other means of controlling trigeminal neuralgia pain. Luckily, there are a number of treatments available that can make a big difference in the level of pain and discomfort you may be experiencing.
Microvascular Decompression
Microvascular decompression surgery (MVD) is the gold standard for effective, sometimes permanent relief from trigeminal neuralgia symptoms. It is used in cases of trigeminal neuralgia where the nerve is being pressed into by a blood vessel. To determine if blood vessel interference is the cause of your trigeminal neuralgia pain, specialized imaging can be requested by your doctor. Specifically, the FIESTA MRI is a specialized imaging procedure that provides a full view of the trigeminal nerve, which helps doctors determine the origin of your trigeminal neuralgia pain. If blood vessel interference is the cause, you may be a candidate for this surgery.
MVD uses state-of-the-art equipment to allow your neurosurgeon to perform surgery through a tiny opening at the base of your skull. A “window” of bone is removed, and a microscope and specialized tools are then used to find the trigeminal nerve and carefully lift the interfering blood vessel away. A tiny Teflon sponge is placed between the nerve and blood vessel, creating a cushioned barrier between the two structures.
The majority of people experience instant trigeminal neuralgia pain relief when this surgery is used. The biggest benefit of MVD surgery is that the nerve is in no way damaged or otherwise compromised, which maintains full nerve function.
Gamma Knife Radiosurgery
Sometimes dubbed “GKRS,” this completely non-invasive procedure doesn’t actually involve surgery in the traditional sense. Instead, Gamma Knife Radiosurgery uses hundreds of tiny beams of radiation focused on the affected area of the trigeminal nerve. This allows for incredibly accurate delivery of a therapeutic dose of radiation therapy. The radiation will damage or kill the offending cells, allowing for a partial interruption of nerve impulses.
GKRS is particularly useful in patients that are not eligible for microvascular decompression, or patients that would prefer to go the non-invasive route. It is also extremely successful when a tumor is present on or near the trigeminal nerve. Nearly every patient that undergoes Gamma Knife Radiosurgery experiences only one treatment session, unlike other radiation treatments that can require several sessions.
Pain Stimulator Placement
When medications don’t work and the aforementioned procedures aren’t feasible, the next option would be pain stimulators. These innovative devices are comprised of tiny electrodes that are threaded underneath the skin and situated on and near the trigeminal nerve. They deliver small pulses of electricity that interrupt the malfunctioning impulses of the trigeminal nerve. This is a minimally invasive procedure that requires very little downtime and typically, does not cause any nerve damage.
Finding the right treatment to address your trigeminal neuralgia pain relief needs can be the difference between living and merely surviving. You and your medical team can review the benefits of each of the above options together. With proper information and guidance, you can regain a sense of well-being and peace of mind.
