Trigeminal neuralgia is an extremely painful disorder caused by disruption of the trigeminal nerve, which supplies sensation to the face and the outer surfaces of the eye. The condition is also known as tic douloureux. There are several treatment options available to cure or diminish the effects of trigeminal neuralgia, including medications, special injections and a number of surgical procedures.
Symptoms
According to the American Association of Neurological Surgeons, trigeminal neuralgia typically manifests as an excruciating, stabbing pain that most commonly affects your lower face and jaw. It usually occurs on only one side of the face, and pain may also extend to the nose and above your eye. These symptoms come and go intermittently, and may worsen during everyday activities like brushing your teeth, drinking, eating or shaving.
Medications
Medications are a common first option to ease trigeminal neuralgia pain. Your doctor will likely begin treatment with an anticonvulsant designed to diminish the pain signals sent to your brain. Options here include phenytoin (Phenytek, Dilantin), carbamazepine (Carbatrol, Tegretol), oxcarbazepine (Trileptal) and gabapentin (Neurontin). A muscle relaxant called Baclofen is sometimes used in combination with phenytoin or carbamazepine. In some individuals, the medication originally prescribed for pain will eventually lose effectiveness. If this occurs, your doctor will switch medications or alter your dosage. According to the Mayo Clinic, many individuals gain sufficient relief from these drug options and require no additional treatment.
Alcohol Injection
In some cases, your doctor may choose to treat your pain with a numbing alcohol injection. Your doctor will make the injection near the borders of the trigeminal nerve in the affected part of your face. While this treatment is effective, it is also temporary, and you may require repeat injections as your pain returns.
Surgery
Surgery may be needed if your pain is not controlled through these more conservative treatment options. If this is the case, several procedures are available to either relieve pressure on your trigeminal nerve or purposefully damage it to control its malfunctions.
In a microvascular decompression, your surgeon will make an incision behind your ear and drill a small hole in your skull. He will then expose your trigeminal nerve and check for obstructions caused by intruding arteries or veins. If an obstructing artery is present, he will move it aside and place padding between it and the nerve. Any obstructing veins will simply be removed. If your surgeon finds that no obstructions are present, he may choose to cut the trigeminal nerve to relieve your symptoms.
In a percutaneous glycerol rhizotomy, your surgeon will guide a needle containing sterile glycerol through your face and into the base of your skull. Next, he will place the tip of the needle in the sac of spinal fluid that surrounds a main branching point of the trigeminal nerve. He will then inject the glycerol, which will slowly damage the nerve and disrupt any pain signals.
Consult your surgeon for the details of other common surgical treatment options.
Tags: trigeminal nerve, your surgeon, doctor will, treatment options, trigeminal neuralgia, your pain, your trigeminal nerve