Misfiring of the trigeminal nerve can cause this pain, which carries our sensations from the brain to the skin of the face. It is most common on one side of the face, though it may also affect both sides at once. Patients may experience more severe pain when eating, brushing their teeth or shaving. Accompanying muscle spasms are usually reported. Blood tests or an MRI of the head may be performed to see if trigeminal neuralgia is indeed present.
This condition is rare in people younger than age 30, and most often affects women over 50 years of age. Although the cause is currently unknown, aging, multiple sclerosis, compression of blood vessels and tumors have all been theorized as possible triggers. In younger patients, the presence of trigeminal neuralgia could indicate another serious illness and should be thoroughly evaluated by a professional.
Non surgical
Trigeminal neuralgia has been treated through various approaches over the years. Medical management through the use of various medications has provided welcome relief for some. Anti-seizure drugs, muscle relaxants or antidepressants have all been utilized to alleviate symptoms related to the disorder. Medical pain specialists will monitor their patients regularly to oversee the problem. As with all medications, managing associated side effects must always be a major consideration to prevent any unforeseen complications.
Surgery
A brain tumor operation may also be used to treat associated trigeminal neuralgia, though in most cases extensive surgery is not needed. Radiation treatments or chemotherapy may first be advised to help reduce the size of the tumor prior to the operation. Surgery may also be recommended to release a blood vessel that is applying pressure to the nerve. Microvascular decompression surgery has been utilized successfully with younger patients to isolate the affected nerve from an associated blood vessel. During surgical procedures, an incision is made in the skin and an opening formed in the bone of the skull. A portion of the bone is then removed to allow access to the target area; this is replaced once the surgery has been successfully completed. Those with preexisting conditions and the elderly are usually treated with precutaneous (needle puncture) methods rather than by opening the skull.
Gamma knife
Since its introduction in treating trigeminal neuralgia, gamma knife surgery has proven to destroy the pain producing source in the vast majority of cases. This radiosurgical procedure specifically destroys the affected target area, such as a tumor, leaving healthy tissue intact. It may also be used to destroy blood vessels in the brain that are placing pressure on a nerve, as may be the case with trigeminal neuralgia. Patients who undergo gamma radiation treatments will have a clear, plastic frame fitted to them on the day of surgery. Individuals are then placed in an apparatus, which consists of a metal, helmet-like device to allow precise radiation beams to be accurately delivered. Treatment does not require anesthesia and patients typically leave the hospital within five hours.
Many patients have reported that radiosurgery for their condition has been highly beneficial in alleviating the pain that they have experienced.