5 Things That You Should Know About Trigeminal Neuralgia 

Trigeminal neuralgia is a painful condition that affects the trigeminal nerve, which is responsible for facial sensations and movements. It is characterized by sudden, severe facial pain that can last for seconds to minutes and can be triggered by activities such as talking, eating, and brushing teeth. The pain is often described as stabbing or shooting and can be so severe that it interferes with daily activities. If you have been diagnosed with this condition or are experiencing facial pain, here are five things you should know about trigeminal neuralgia surgery:  

Initial trigeminal neuralgia treatment is always medication

The first line of trigeminal neuralgia treatment is usually medications that are used to treat epilepsy, such as carbamazepine and gabapentin. These medications work by decreasing the activity of the trigeminal nerve and can be effective in reducing the frequency and severity of the pain.

Medications may not always provide adequate pain relief 

While medications are the first line of trigeminal neuralgia treatment, they may not always provide sufficient pain relief. A systematic review of previous research found that 50% of patients eventually undergo one or more additional interventions, such as surgery, percutaneous radiofrequency nerve ablation, or other procedures, to manage their pain.     

MVD is the treatment of choice for many patients

MVD, or microvascular decompression, is a surgical procedure that involves repositioning the blood vessels that are pressing on the trigeminal nerve, which can cause this condition. MVD has the highest success rate and lowest recurrence rate among all the available interventions and is often recommended for patients without significant co-morbidities (other health conditions).  

Radiosurgery has a higher risk of recurrence

Another option for treating this condition is radiosurgery, which involves using high-energy radiation to destroy the trigeminal nerve. While radiosurgery can be effective in reducing pain, it has a higher risk of recurrence compared to MVD and is usually reserved for older patients or those with significant co-morbidities.  

There is limited evidence for newer treatment modalities  

There are a few newer trigeminal neuralgia treatment modalities, such as baclofen injection and spinal cord stimulator insertion, but there is limited evidence to support their effectiveness. More research is needed to determine the long-term safety and efficacy of these treatments.  

In conclusion, the trigeminal neuralgia treatment typically begins with medications, but additional interventions may be necessary for adequate pain relief. Trigeminal neuralgia surgery option includes MVD and radiosurgery. MVD is the treatment of choice for many patients, while radiosurgery is reserved for older patients or those with significant co-morbidities. There is limited evidence for newer treatment modalities, and more research is needed to determine their effectiveness.  

The pain and anxiety due to this condition hamper the quality of life of the person suffering from this condition. The patient may experience temporary or permanent numbness on the face. When the first medicine fails to control the pain or if there are severe side effects from the medicines, you should consult a Neurosurgeon.  

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Dr. Arun Rajeswaran

Consult Dr. Arun with a professional experience of more than 13 years in the field of Neurosurgery

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