Trigeminal Neuralgia, also called tic douloureux, is a disorder of the trigeminal nerves that carry sensation to the face. Patients afflicted with this disorder experience debilitating pain on one side of the face. Many often describe this pain as a sudden, stabbing, electric shock-like pain in the forehead, nose, lips, and/or jaw. Because the second and third divisions of the trigeminal nerve are most commonly affected, you can usually feel the pain in the lower half of the face, causing some people to first seek treatment from their dentist.
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ATYPICAL TRIGEMINAL NEURALGIA
A less common form of the disorder called “Atypical Trigeminal Neuralgia” may cause less intense, constant, dull burning or aching pain. Sometimes, the condition presents with occasional stabbing jolts. Both forms of the trigeminal nerve disorder usually affect one side of the face, but sometimes patients experience pain on both sides.
The onset of symptoms of Trigeminal Neuralgia usually occurs in mid to late life. However, cases in children and even infants have been documented. Something as simple and routine as brushing the teeth, putting on makeup or even a slight breeze can trigger attacks of pain. The most subtle touch may trigger an agonizing attack for the individual.
In many cases, you can manage trigeminal neuralgia well with a variety of anti-seizure medications that help “stabilize” the nerve that stimulates pain by reducing irritation. The neurosurgeons at ONS are highly experienced in prescribing, monitoring, and adjusting these medications. In addition, alternative therapies such as acupuncture, can be important adjuncts to medication.
If medication fails, surgery may be an option to reduce the intensity and frequency of the painful shocks. In some cases, surgery completely cures trigeminal neuralgia.
Depending on the severity of the condition, the surgeon can insert a needle through the cheek into the cavity where the trigeminal nerve sits. He or she damages the pain fibers of the nerve by chemical, mechanical, or electrical means.
In a more complex procedure, the surgeon examines the trigeminal nerve with a microscope and moves the compressed blood vessels away from the nerve. He or she will place a padded material (typically made of Teflon) between the nerve and the blood vessel to prevent the vessel from coming in contact with the nerve again. The surgeon will perform the operation under general anesthesia through a small opening in the back of the skull.
The Cyberknife® Robotic Radiosurgery System at Stamford Hosptal is used to precisely focus beams of radiation onto the trigeminal nerve. The procedure is non-invasive, painless and requires no incision. The patient goes home the same day after treatment.