Trigeminal Neuralgia is a particular type of facial pain along the trigeminal nerve path. This fifth cranial nerve provides sensation from the forehead down to the chin along with control of the masticating (chewing) muscles. The trigeminal nerve has three branches: the ophthalmic, maxillary and mandibular that correspond to the upper, middle and lower parts of the face.
Causes and Symptoms of Trigeminal Neuralgia
Trigeminal neuralgia (TN) affects either the left or the right side of the face (ipsilateral), but not usually both sides. Nor does TN cause neck pain. This severe face pain can be spontaneous and often is described as:
shooting, stabbing or burning pain
electric-shock like pain
brief, acute and excruciating pain
These episodes can last seconds or minutes. The pain occurs at irregular intervals, although routine activities can trigger an episode:
light touching of the skin such as being kissed or applying make-up
shaving or washing your face
talking or smiling
These painful trigeminal neuralgia symptoms can be very debilitating and can develop into facial tics, hence the condition is sometimes called tic douloureux.
Trigeminal Neuralgia is most often caused by pressure on the trigeminal nerve sending pain signals to the brain. The pressure on the nerve can be caused by:
an artery or vein in the brain,
aneurysm (the weakened wall of a blood vessel that becomes engorged),
chronic inflammation of the meninges (membranes covering the brain and spinal cord),
and rarely, a tumor.
Damage to the myelin sheath (the insulating covering of nerve fibers) from conditions such as multiple sclerosis (MS) can also contribute to TN.
Atypical trigeminal neuralgia is different from TN, in that in addition to TN, the pain can become more constant and widespread, without the periods of remission or relief. It can also travel to the other side of the face. The nature of the pain may be similar to a migraine.
How Is Trigeminal Neuralgia Diagnosed?
An accurate diagnosis of your facial pain is the key to the best treatment plan for you. Many disorders and diseases can cause pain in the forehead, around the eye, or in the jaw or neck. Diagnostic neuroimaging such as an MRI (magnetic resonance imaging) or CT (computerized tomography) scan can help our neurologists determine if your TN is caused by damaged myelin from MS or a tumor compressing the nerve.
Having specialists in facial pain such as trigeminal neuralgia, glossopharyngeal neuralgia or vagoglossopharyngeal neuralgia, and postherpetic neuralgia diagnose your facial pain means you are more likely to have successful treatment results. At NSPC in Long Island, you can find internationally recognized experts in trigeminal neuralgia treatment and all the necessary facilities.
What Are the Treatments for Trigeminal Neuralgia?
Sometimes Trigeminal Neuralgia can go into spontaneous remission, often helped by anti-seizure medications.
At Neurological Surgery, P.C. (NSPC) in New York, we have expert doctors who specialize in treating trigeminal neuralgia, with the most advanced techniques available.
Microvascular Decompression Surgery is a microsurgical procedure to cure the TN by removing the pressure (decompression) on the nerve. One of our expert neurosurgeons makes a tiny hole in the skull and, using a microscope and other small tools, carefully places a cushion between the trigeminal nerve and the blood vessel that is squeezing it.
The following trigeminal neuralgia surgery treatments work by injuring the nerve and causing a disruption of the pain signal to the brain. These are less invasive procedures than the microvascular decompression surgery, but can take longer to see results:
Rhizotomy is a surgical procedure to sever the nerve root. This is usually an outpatient procedure. It is percutaneous (done through the skin); a small needle is inserted and depending on the type of rhizotomy either heat, alcohol, glycerol or a balloon is introduced to the nerve.
The Gamma Knife procedure uses stereotactic radiation to deliver precise gamma rays to the nerve. This injures the nerve and interferes with the transmission of the pain signal.
NSPC offers premier trigeminal neuralgia surgical treatments along with other facial pain treatment plans in the NY area, including New York’s Queens, Nassau and Suffolk Counties.