Trigeminal neuralgia
What is trigeminal neuralgia?
Trigeminal neuralgia is a disorder of one or both of the
facial nerves.
What are the symptoms of trigeminal neuralgia?
Symptoms are episodes of intense pain normally on one side of
the face. The pain is often triggered by sensory stimuli such
as touching the skin of the face, eating or brushing teeth. In the
majority of cases the cause remains unknown. It is, however,
commonly believed that injury to the trigeminal nerve root caused
by pressure from a pulsating blood vessel is the cause in most
cases. It also, but rarely, occurs as a complication to multiple
sclerosis. A benign tumour is also a rare causative factor.
How is trigeminal neuralgia diagnosed?
The diagnosis is normally made based on the crecognised clinical
characteristics. An MRI (magnetic resonance imaging)
scan is usually made to rule out the rare occurrence of secondary
trigeminal neuralgia.
How is trigeminal neuralgia treated?
The first line of treatment is drug therapy. Carbamazepine
(Tegretol) is the most commonly used drugs but others are
available. There are numerous surgical procedures available for
drug resistant pain. Microvascular decompression is a procedure
intended to move the blood vessel compressing the nerve root close
to the brain stem. For this procedure a craniotomy under general
anaesthesia is required. Other procedures such as glycerol
rhizotomy and radiofrequency thermocoagulation are done by
inserting a cannula or needle into the opening for the nerve root
in the skull base. The latter procedures are usually done under
local anaesthesia or brief general anaesthesia.
Gamma Knife surgery is becoming increasingly popular because of
its efficacy and popularity with patients. The procedure has been
in frequent use only during the past 6-7 years and therefore
reports on long term follow up are still needed. Should the short
term results reported prove to be lasting, this procedure may
become the first treatment option for trigeminal neuralgia.
Further information on trigeminal neuralgia
Please contact the Gamma Knife Centre directly or go to
The Trigeminal Neuralgia
Association