Trigeminal neuralgia is a neuropathic disorder affecting the fifth cranial nerve - trigeminal nerve. The condition features with intensive, sharp and extremely severe pain in the area of face which is innervated by trigeminal nerve. These areas include the eyes, nose, scalp, forehead, lips, and both upper and lower jaw. The real cause of trigeminal neuralgia has not been found yet.
Medicamentous Treatment of Trigeminal Neuralgia
In case of trigeminal neuralgia patients may be administered some of the anticonvulsants. They are normally given in patients who suffer from seizures but they have proven certain extent of efficacy in treating trigeminal neuralgia. These medications can relieve pain in the mild cases of the disease.
Muscle relaxants are another group of medication that is used. Their efficiency is increased if they are used together with anticonvulsants. The patients may present the loss of pain after certain period and then they discontinue with the medications. Unfortunately in many patients the pain comes back.
Surgical Approaches in Trigeminal Neuralgia
For all those who cannot control the pain with medication there are several surgical procedures that may result in reduction or even complete elimination of pain. Some surgical procedures can be combined with medications in achieving the desirable effects. Surgery is done to destroy certain parts of trigeminal nerve. InjectionsInjections with alcohol or glycerol have been used in patients suffering from trigeminal neuralgia. Alcohol injections may need to be repeated as the primary effect wears off. As for glycerol injections they are applied at the place where the nerve exits the base of skull. This procedure requires X ray guidance so the surgeon can be sure he/ she is injecting glycerol into the correct spot.Balloon CompressionBalloon compression is surgical procedure in which a needle is inserted percutaneously through the face and then into the hole at the base of the skull. The balloon is present at the end of the catheter. This catheter is conveyed through the needle and the balloon is inflated. The compression onto the nerve relieves the pain.Electric currentIn some cases electric current is used to destroy specific parts of the nerve. This is done in percutaneous stereotactic radiofrequency thermal rhizotomy. In case that the pain does not vanish after the first attempt additional damage to the nerve by the electric current is usually performed. Stereotactic RadiosurgeryThis surgical procedure uses radiation to damage the nerve. Stereotactic surgery is not painful and there is no need for anesthesia. Microvascular decompressionThis is another surgical option in treating trigeminal neuralgia. The goal of this surgical procedure is to resect and remove specific blood vessels that supply the nerve with blood. This means that the nerve is not destroyed directly. It is performed in hospitals under general anesthesia.
All of the mentioned procedures may lead to temporary facial numbness as one of the side effects.