What is trigeminal neuralgia surgery?
Trigeminal neuralgia surgery is a treatment for nerve pain (neuralgia) that is caused by the trigeminal nerve. The trigeminal nerve exits the brain directly through the skull to supply sensation to the face. The procedure frees the trapped nerve and stops the transmission of pain signals from the trigeminal nerve to the brain.
Trigeminal neuralgia, also known as tic douloureux, is a type of severe nerve pain in the forehead, cheek, teeth and jaw, usually affecting one side of the face.
Types of trigeminal neuralgia treatments
- Microvascular decompression: This procedure is an open surgery in which the surgeon makes a small opening in the skull (craniotomy) and places a Teflon sponge between the trigeminal nerve and the impinging blood vessel.
- Percutaneous procedures: These procedures are minimally invasive and involve insertion of a needle into the bundle of nerves where the three branches of the trigeminal nerve join (Gasserian ganglion). There are three kinds of percutaneous procedures:
- Percutaneous radiofrequency trigeminal gangliolysis (PRTG) or radiofrequency rhizotomy: An electric current is passed through the needle, producing a thermal lesion in the Gasserian ganglion and disrupting the pain signals.
- Percutaneous balloon decompression (PBM): A balloon is inserted and inflated in the Gasserian ganglion for up to 10 minutes to damage it and block the pain signals.
- Percutaneous retrogasserian glycerol rhizotomy (PRGR): Glycerol is injected to destroy the pain transmitting nerve fibers in the Gasserian ganglion.
- Gamma Knife surgery: Also known as stereotactic brain radiosurgery, this procedure is the least invasive. The Gamma Knife delivers precise, controlled beams of radiation to the trigeminal nerve where it connects to the brain stem and thereby directly stops the pain signal transmission.
Is trigeminal neuralgia surgery brain surgery?
Trigeminal neuralgia surgery is not a brain surgery as it does not affect the brain. Microvascular decompression surgery involves making an opening in the skull and the membrane (dura) covering the brain, to access the trigeminal nerve. The brain itself is untouched during the surgery. The percutaneous procedures are minimally invasive with only a needle insertion directly in the nerve, while Gamma Knife surgery is a targeted delivery of radiation to the nerve.
Why is a trigeminal neuralgia surgery performed?
The trigeminal nerve is the cranial nerve responsible for sensations in the face and motor functions like biting and chewing. The trigeminal nerve has three main branches on each side of the face, sending and receiving signals between the brain and the facial tissues.
When the trigeminal nerve is irritated, it can result in trigeminal neuralgia that can be debilitating. A blood vessel pressing on the trigeminal nerve is the most common cause of trigeminal neuralgia.
Other causes of the trigeminal nerve compression include
- Tumor
- Aneurysm
- Arteriovenous malformation
- Multiple sclerosis
Trigeminal neuralgia may be
- Typical: sudden, unpredictable attacks of stabbing, electric shock-like pain in a consistent location, usually caused by a trigger such as touching the face, chewing or talking.
- Atypical: persistent dull ache or burning sensation in one side of the face, with or without episodes of sharp pain, without any triggers.
Without treatment, typical trigeminal neuralgia can progress to the atypical kind. Trigeminal neuralgia usually worsens over time, with periods of remission between the episodes becoming shorter. For many people, medications lose efficacy over time and increase in dosage comes with complications of the drug side effects.
Trigeminal neuralgia surgery is performed when
- Medications are not effective in controlling the pain
- Patients are intolerant to medications
- Other previous treatment procedures have failed
SLIDESHOW
Rheumatoid Arthritis Exercises: Joint-Friendly Workouts See SlideshowTop Is Trigeminal Neuralgia Surgery Brain Surgery Related Articles
capsaicin topicalCapsaicin topical is a pain-relieving (analgesic) medication available as over-the-counter (OTC) as topical creams, gels, and liquids used for the temporary relief of minor joint and muscle pains due...- capsaicin transdermalCapsaicin transdermal is a medicated skin patch applied for the relief of nerve pain (neuralgia) and musculoskeletal pain. The Qutenza brand of capsaicin transdermal is a prescription patch used to...
- capsicumThe medicinal property of capsicum comes from capsaicin, an oleoresin and the active compound in chili peppers. Capsaicin may be taken orally in food, lozenges, and other products, and applied on the...
Why Does My Head Ache?Find out what's behind your headache, and get some strategies to bring you relief for your pain.- lidocaine transdermalLidocaine transdermal is a transdermal skin patch used to relieve postherpetic neuralgia (PHN), which is nerve pain after an attack of shingles. Common side effects of lidocaine transdermal include...
Nerve Pain SlideshowLearn about nerve pain symptoms, causes, and treatment options. Discover medications and natural remedies to relieve nerve pain.
Neuropathic Pain (Nerve Pain)Neuropathic pain is a chronic condition that leads to ongoing pain symptoms. Patients can be predisposed to developing neuropathic pain who have conditions such as diabetes, cancer, stroke, HIV,...- oxcarbazepineOxcarbazepine is an anticonvulsant used in the treatment of partial (focal) onset seizures in both adults and pediatric epileptic patients. Oxcarbazepine may also be used to treat bipolar disorder...
Pain ManagementThe goal of pain management for each patient is to minimize suffering and improve quality of life. This goal may be different depending on the patient’s circumstances and disease or injury.
Pain Management: Neuropathic PainNeuropathic pain is chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside...
Pain QuizIs pain all in the brain? Take the Pain Quiz to learn everything you've ever wanted to know about the unpleasant sensation we call pain.
Pain Management: Surprising Causes of PainWhat's causing your pain? Learn the common causes of lower back pain, as well as pain in the knee, stomach, kidney, shoulder, chest, gallbladder, heel, sciatic nerve, neck, hip, foot and other parts...- LyricaLyrica is a drug prescribed for the treatment of neuropathic pain associated with diabetic peripheral neuropathy or post neuralgia; partial onset seizures in adults; and fibromyalgia. Side effects...
- propofolPropofol is an intravenous anesthetic drug used for general anesthesia and sedation during surgical procedures. Common side effects of propofol include injection site burning, stinging or pain; low...
15 Ways to Reduce PainChronic pain can be a symptom of many conditions, including arthritis, headaches, and others. Comprehensive chronic pain management therapy may include physical therapy, lifestyle strategies such as...- selumetinib (Koselugo)Selumetinib (Koselugo) is a prescription medication used to treat children 2 years of age and older diagnosed with neurofibromatosis type 1 (NF1) and have plexiform neurofibromas that cannot be...
- succinylcholineSuccinylcholine is a skeletal muscle relaxant used for medical procedures done under general anesthesia, including tracheal intubation, mechanical ventilation, and surgeries. Common side effects of...
Trigeminal NeuralgiaPain that originates in the face is referred to as trigeminal neuralgia. This pain may be caused by:-
$2
$2
$2
$2
What Is Intraoperative Neurophysiological Monitoring?Intraoperative neurophysiological monitoring is the continuous evaluation of a patient’s nervous system during surgery, especially procedures involving the brain and spinal cord. Electrical and...
What Is Ventriculoatrial Shunt Placement?Ventriculoatrial shunting (VAS) is a procedure that allows the cerebrospinal fluid (CSF) to flow from the brain to the atrium of the heart. This procedure is typically used to treat a condition...