Stephen J. Schueler, M.D.

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Tic Douloureux Surgery

Those who do not respond to medication may be candidates for a surgery.

Surgery for trigeminal neuralgia may involve:

  • Relieving pressure on the trigeminal nerve
  • Surgical destruction of the trigeminal nerve fibers

Surgery for trigeminal neuralgia
  • Microvascular decompression (MVD):
    • Surgically separating blood vessels from a position next to the trigeminal nerve reduces pressure on the nerve and relieves pain.
  • Percutaneous balloon microcompression of the trigeminal nerve (PBM):
    • A catheter is inserted through the skin of the face
    • A balloon is inflated through the catheter
    • The catheter places pressure on the trigeminal nerve, destroying the nerve
  • Percutaneous radiofrequency rhizotomy (RZ):
    • A needle is inserted through the skin of the face
    • An electrode is placed through the needle
    • The electrode burns the pain fibers in the trigeminal nerve
  • Gamma-knife radiosurgery (GKR):
    • Delivers a focused beam of radiation to the trigeminal nerve to relieve pain
    • Effective for about 80% of those who have the procedure done
    • Pain relief may be gradual
    • No anesthesia is required
    • May cause some numbness in the face.

Continue to Tic Douloureux Home Care

Last Updated: Jan 6, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Tic Douloureux References
  1. Bagheri SC, Farhidvash F, Perciaccante VJ. Diagnosis and treatment of patients with trigeminal neuralgia. J Am Dent Assoc. 2004 Dec;135(12):1713-7. [15646605]
  2. Cheshire WP. Trigeminal neuralgia: diagnosis and treatment. Curr Neurol Neurosci Rep. 2005 Mar;5(2):79-85. [15743543]
  3. Urgosik D, Liscak R, Novotny J Jr, Vymazal J, Vladyka V. Treatment of essential trigeminal neuralgia with gamma knife surgery. J Neurosurg. 2005 Jan;102 Suppl:29-33. [15662776]
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