trigeminal-neuralgia-and-available treatments
27 June, 2020 Tibss

Trigeminal Neuralgia and available treatments | TIBSS

Trigeminal neuralgia is a severe pain condition that damages the trigeminal nerve, which carries sensation from your face to your head. If you are suffering from trigeminal neuralgia, even mild stimulation of your face — such as from brushing or doing some makeup — may trigger a lot of pain.

Initially, you can also notice short, mild attacks. But trigeminal neuralgia can rise and provide more prolonged, more-frequent bouts of severe pain. It usually affects women more as compared to men, and it's more likely to happen in people who have the age of more than 50 years.

Because there are various options of treatments available, having trigeminal neuralgia doesn't mean that you have to live a life of pain. Expert doctors usually can greatly treat trigeminal neuralgia with medications, injections or surgery.

Causes of Trigeminal Neuralgia

In trigeminal neuralgia, the trigeminal nerve's function is damaged. Usually, the disease is contact between an artery or a vein and the trigeminal nerve at the root of your brain. This contact raises pressure on the nerve and causes it to disturbance.

Trigeminal neuralgia can happen as a result of getting older, or it can occur due to various sclerosis or the same disorder that destroys the myelin sheath acting as a security guard for specific nerves. Trigeminal neuralgia can also be caused by a tumour putting pressure on the trigeminal nerve.

Some persons may notice trigeminal neuralgia due to a brain injury or other abnormalities. In other cases, stroke or facial trauma, surgical injuries, or facial trauma may be some of the causes of trigeminal neuralgia.

Available Treatments for Trigeminal Neuralgia

This disease’s treatment often begins with medicines, and some patients don't need any other treatment. However, over time, some patients with the condition may stop giving any response to drugs, or they may notice unpleasant side effects.

For those patients, surgery or injections offer other treatment options. If you have this disease due to another cause, such as multiple sclerosis, your consultant will provide treatment for the underlying condition.

Medicines for Trigeminal Neuralgia

  • Antispasmodic agents : Baclofen (Gablofen, Lioresal) can be utilized alone or in combination with carbamazepine to cure the disease. It includes some side effects like nausea, confusion, and drowsiness.

  • Anticonvulsants : Brain specialists usually suggest carbamazepine (Tegretol, Carbatrol, others) for the disease, and it's been shown to be highly emphatic in treating the disease. Other anticonvulsant medicines include lamotrigine (Lamictal), phenytoin (Dilantin, Phenytek), and oxcarbazepine (Trileptal), clonazepam (Klonopin), (Neurontin, Gralise, others), and gabapentin. Side effects of this medicine include confusion, dizziness, nausea, and drowsiness.

  • Botox injections : According to experts, onabotulinumtoxinA (Botox) injections can reduce pain due to trigeminal neuralgia in patients who no longer get any response from medicines. However, more research is required before this treatment is widely utilized for this problem.

Surgery for Trigeminal Neuralgia

  • Brain stereotactic radiosurgery (Gamma knife) During this surgery, a neurosurgeon injects a focused dose of radiation to the base of your trigeminal nerve. This surgery utilized radiation to destroy the trigeminal nerve and eliminate severe pain. The recovery happens gradually and may take up to 25 to 30 days.
    Brain stereotactic radiosurgery is a very effective treatment in reducing pain for the majority of patients. If pain rehappens, the procedure can be repeated. Facial numbness is a side effect of this treatment.

  • Microvascular decompression This surgery includes relocating or removing blood vessels that have a connection with the trigeminal base to prevent the nerve from malfunctioning. During this procedure, your surgeon makes a cut behind the ear on the side of your pain.
    Then, with the help of a small hole in your skull, your brain doctor moves any arteries that have a connection with the trigeminal nerve away from the nerve and puts a lightweight cushion between the nerve and the arteries.
    If a vein is disturbing the nerve, your neurosurgeon may remove it. Brain doctors may also cut a small portion of the trigeminal nerve (neurectomy) during this process if arteries aren't pressing on the nerve.
    This procedure comes with some risks, including numbness, facial weakness, decreased hearing, a stroke or other complications.

Other procedures for Trigeminal Neuralgia

Some other processes may be utilized to treat this disease, such as a rhizotomy in which your surgeon removes nerve fibres to prevent pain, and this causes some facial numbness. Types of rhizotomy are:
  • Balloon compression In this procedure, your neurosurgeon puts a hollow needle through your face and forwards it to a portion of your trigeminal nerve that goes through the root of your skull.

    Then, your neurosurgeon connects a thin catheter with a balloon on end through the needle. Your brain doctor fills the balloon with enough pressure to destroy the trigeminal nerve and block pain signals.

    Balloon compression is a very successful technique to reduce pain in most patients, at least for some time. Most patients undergoing this technique notice at least some transient facial numbness.

  • Radiofrequency thermal lesioning This process damages explicitly nerve fibres associated with severe pain. Your surgeon puts a hollow needle through your face and forwards it to a portion of the trigeminal nerve that proceeds through an opening at the root of your skull.

    Once the needle is inserted, your brain doctor will make you conscious. Your neurosurgeon puts an electrode through the needle and generates a mild electrical current through the tip of the electrode.

    When your neurosurgeon locates the portion of the nerve included in your pain, you're returned to unconsciousness. Then the electrode is heated enough to destroy the nerve fibres, building an area of injury. If your pain isn't reduced, your neurosurgeon may create new lesions.

    Radiofrequency thermal lesioning usually comes with temporary facial numbness. Pain may occur again after three to four years.

  • Glycerol injection During this process, your surgeon puts a needle through your face and proceeds towards an opening in the root of your skull. Your neurosurgeon forwards the needle into the trigeminal cistern, a small sac that covers the trigeminal nerve ganglion — where the nerve partitioned into three branches — and part of its base.

    Then, your surgeon will give a small amount of sterile glycerol, which destroys the trigeminal nerve and blocks pain signals. This process usually prevents pain. However, some patients have the issue of pain again, and many notice facial numbness or tingling.

Wrapping up

Living with this disease can be a tough task. The condition may harm your interaction with your loved ones, your productivity at your job place, and the overall quality of your life.

Make an appointment with the best neurosurgeons at TIBSS if you have common symptoms of trigeminal neuralgia. We are trained in the diagnosis and treatment of brain and nervous system conditions.

Doctors at TIBSS, the best brain and spine hospital in Chandigarh, have access to the newest tools, such as intraoperative MRI, Gamma Knife radiosurgery, and stereotactic radiosurgery. Through our high-tech procedures, we are dedicated to providing you with a pain-free and healthy life.