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Neuroscience: Trigeminal Neuralgia

About Trigeminal Neuralgia

Trigeminal neuralgia, also known as “tic douloureux,” is a disorder of a cranial nerve resulting in stabbing pain that radiates to the mouth, cheek, forehead, nose or other areas of the face. The exact cause of trigeminal neuralgia is not fully understood.

Diagnosis
Diagnosis of trigeminal neuralgia is based on a history and physical exam by a physician. If your doctor suspects you have this disorder, he may refer you to one of our board-certified neurosurgeons. Your doctor or specialist may use some of the following methods to arrive at a diagnosis: 

  • Magnetic Resonance Imaging (MRI) – This diagnostic tool, which uses magnetic scanning, is useful in eliminating other possible conditions, such as a brain tumor, in order to confirm a suspected diagnosis of trigeminal neuralgia.
  • Computerized Tomography (CT) scan – Also known as a CAT scan, this advanced x-ray technology is useful in eliminating other possible conditions, such as a brain tumor, in order to confirm a suspected diagnosis of trigeminal neuralgia. 

Treatment Options
Treatment for trigeminal neuralgia depends on a number of factors, including the patient’s age and general health. If you are diagnosed with trigeminal neuralgia, your physician may recommend any one or a combination of the following treatment options:

  • Medication – Typically anticonvulsives or muscle relaxants, which help control pain for many people. The effectiveness of the medication may decrease over time.
  • Gamma Knife surgery  – A highly specialized technology with sub-millimeter accuracy, it relies on three-dimensional computer-assisted planning to target and then desensitize the nerve with high-energy radiation. This type of surgery doesn’t require opening the skull or damaging other brain tissue, yet it provides about 85 percent of patients complete or partial pain relief within one year of treatment, offering new hope to many trigeminal neuralgia patients throughout the world, including here in Michigan.
  • Microvascular decompression (MVD) – A surgical procedure that relocates or removes blood vessels to prevent them from coming into contact with the trigeminal nerve root.
  • Balloon compression – A balloon on the end of a thin, flexible tube (catheter) that is inserted into the trigeminal nerve, then inflated to compress the nerve and block pain signals.
  • Injections – Involves glycerol injections into the trigeminal nerve to block pain signals. Pain relief is usually not permanent and injections may need to be repeated. A previous approach using injections of alcohol is no longer used.
  • Electric current – Also known as percutaneous stereotactic thermal rhizotomy. This involves threading an electrode into a needle injected into the trigeminal nerve. Once heated, the electrode damages the nerve fibers, which blocks the pain. 

The MidMichigan Difference

  • A statewide leader in neuroscience and cancer care in Michigan
  • Board-certified neurosurgeons and radiation oncologists specially trained and experienced in a variety of treatment methods, including Gamma Knife® surgery.
  • Three hospitals and four radiation oncology centers located in safe and friendly communities in the middle of Michigan 

Gamma Knife® is a registered trademark of Elekta Group.

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Resource Library
  • Gamma Knife Information from Brain and Spine Surgery of Midland, Michigan
  • Educational information about brain conditions from International Radiosurgical Association (IRSA)
  • Patient forums (bulletin boards) on various brain conditions at IRSA.org
  • Neurosurgeons Use Gamma Knife Radiosurgery for Treatment of Trigeminal Neuralgia (summary of 2001 study by American Assocation of Neurological Surgeons)
  • Trigeminal Neuralgia Association
  • Trigeminal Neuralgia Information Page at the National Institute of Neurological Disorders and Stroke (a division of nih.gov)
  • Evidence-based guidelines for patients with intractable typical trigeminal neuralgia who have failed medical management from the National Guideline Clearinghouse (guideline.gov)
    In this Section
    Back & Neck Pain
    Brain Tumors & Abnormalities
    Epilepsy
    Deep Brain Stimulation
    Headaches
    Multiple Sclerosis
    Parkinson’s Disease
    Sleep Disorders
    Stroke
    Trigeminal Neuralgia
    Gamma Knife
    Testimonial
    Gamma Knife Treatment Ends Twenty-Year Bout with Facial Pain
    Nick Frontczak
    Attorney and trigeminal neuralgia patient
    " My treatment was a tremendous success. I would encourage anyone who is suffering with trigeminal neuralgia, and is unable to control it with medications, to consider having a Gamma Knife treatment. "
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