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 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 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. It provides good to excellent results for 85-90 percent of patients, 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.