Trigeminal Neuralgia Fact Sheet
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Trigeminal neuralgia treatment at UK HealthCare
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Gamma Knife radiosurgery, a state-of-the-art, non-invasive procedure that uses highly focused gamma rays to safely treat conditions such as trigeminal neuralgia.
What is trigeminal neuralgia?
Trigeminal neuralgia (tri-jeh-mih-null ner-all-juh), also known as tic douloureux (tik do-luh-rew), is a painful condition that affects the trigeminal nerve or fifth cranial nerve. The trigeminal nerve, one of the largest nerve in the head, is responsible for detecting touch, pain, temperature and pressure in areas of the face between the jaw and forehead and around the eyes.
Trigeminal neuralgia is characterized by a sudden, intense, "stabbing" or "shock-like" facial pain typically felt on one side of the jaw or cheek. Trigeminal neuralgia affects slightly more women than men. The first episode of facial pain usually occurs in people 50 to 70 years old. Although children and young adults may experience trigeminal neuralgia, it is rare in people younger than 40.
An attack of trigeminal neuralgia can last from a few seconds up to two minutes. Most people describe the pain as excruciating, sharp, stabbing, piercing, burning or like an electric shock. Attacks may begin as short and mild but can become longer and more frequent as the condition progresses.
The painful attacks can be spontaneous or triggered by certain movements or stimuli including talking, eating, washing your face, brushing your teeth, putting on makeup, shaving or even something as light as a gentle breeze. The pain may occur in a small area of your face or rapidly spread over a larger area.
Approximately 50 percent of patients report a specific trigger point or zone on the face. The zone is usually located between the lips and nose. A touch or temperature change in this area can trigger an episode. A tingling sensation or numbness is sometimes experienced before the pain.
Diagnosing trigeminal neuralgia
Your doctor will review your medical history and ask questions about your symptoms. This will rule out any medical or dental conditions that have similar symptoms. A thorough examination of your head and neck, including the area inside your mouth, and a neurological exam will also be needed to make a diagnosis of trigeminal neuralgia.
Several treatment options exist for trigeminal neuralgia including drug therapy, Gamma Knife radiosurgery, rhizolysis and microvascular decompression.
Your doctor may begin treating your trigeminal neuralgia with anticonvulsant medications. These medications decrease the ability of the trigeminal nerve to send impulses that cause facial pain. As with most medicines, you may experience side effects that include drowsiness, dizziness or nausea.
Gamma Knife radiosurgery
Gamma Knife radiosurgery uses radiation therapy to inactivate part of the trigeminal nerve.
In rhizolysis, part of the trigeminal nerve is temporarily inactivated by using a heated probe or an injection of the chemical glycerol. These procedures typically provide immediate relief but many patients will have symptoms return during the next several years.
Microvascular decompression is a surgical procedure where a surgeon repositions the blood vessel that presses on your trigeminal nerve. This procedure is a surgical intervention and requires a healthy candidate. It may not be recommended for patients who have had little success with less invasive interventions.
UK HealthCare Gamma Knife Center
Trigeminal Neuralgia Association
American Chronic Pain Association