Trigeminal neuralgia is a chronic condition affecting the trigeminal nerve, which is responsible for carrying sensation from your face to your brain. This condition can produce sudden, severe, shock-like feelings of pain along the face.
Trigeminal neuralgia is caused by a blood vessel compressing the trigeminal nerve. Those with this condition may experience excruciating pain while performing seemingly simple activities, like washing their face or brushing their teeth.
The trigeminal nerve has three sections, which affect:
Blood-vessel compression of the trigeminal nerve causes trigeminal neuralgia. Pain from trigeminal neuralgia may be triggered by activities that involve stimulating the face:
It can occur in one or all areas, though symptoms usually begin on one side of the face, and affect both sides in about 5 percent of people.
Atypical trigeminal neuralgia shares several symptoms of trigeminal neuralgia. Microvascular decompression surgery may be indicated in certain cases, but the effectiveness of this treatment for atypical trigeminal neuralgia is less favorable.
Trigeminal neuralgia is first treated medically before surgery is considered as a treatment option. If medication is not effective, UPMC neurosurgeons usually recommend Microvascular Decompression. This minimally invasive surgery treats the cause of the problem, offers the most long-lasting relief, and minimizes risk of postoperative side effects like numbness.
UPMC’s high volume of trigeminal neuralgia patients has allowed our surgeons to research treatment effectiveness, making UPMC a world leader in the management and treatment of both trigeminal neuralgia and atypical trigeminal neuralgia.
Your doctor may ask about any symptoms you are experiencing.
Symptoms of trigeminal neuralgia often include:
MRI scans with and without an injected contrast dye are essential to diagnosis because similar symptoms can occur due to:
Trigeminal neuralgia is first treated with anticonvulsant drugs, and doctors may prescribe other medications as well. In many cases, patients are:
In such cases, UPMC surgeons usually recommend one of the following treatments:
Microvascular decompression is a minimally invasive surgical procedure using endoscopes that:
Microvascular decompression relieves abnormal compression of a cranial nerve. The surgery consists of a linear incision behind the ear followed by a craniectomy (bony opening) the size of a silver dollar.
Under the view of a microscope or endoscope, the surgeons detect the area where the blood vessel is affecting the nerve and then separate them, leaving a Teflon "pillow" in between.
Each year, more than 500 people with trigeminal neuralgia are treated at UPMC, including about 100 who undergo microvascular decompression.
This high volume allows doctors here to pursue research aimed at improving treatment effectiveness, making UPMC a world leader in the management of trigeminal neuralgia.
In the last 25 years, UPMC neurosurgeons have treated more than 20,000 patients with trigeminal neuralgia. Treatment provides:
One year after surgery:
Major complications occur in fewer than 5 percent of cases.
Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.
Patients with typical trigeminal neuralgia who have had an adequate trial of medications can be offered Gamma Knife treatment. It is typically used for
UPMC is the nation’s leading provider of Gamma Knife procedures. Over its 25-year history at UPMC, Gamma Knife stereotactic radiosurgery has proved effective for nearly 12,000 patients with: