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):
- Separating the blood vessels from contact with the trigeminal nerve
- Percutaneous balloon compression of the trigeminal nerve (PBCTN):
- 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 stereotactic radiofrequency thermal rhizotomy (PSRTR):
- 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
- Partial sensory rhizotomy (PSR):
- Surgical procedure to cut the trigeminal nerve at the base of the skull
- Gamma-knife radiosurgery (GKR):
- Delivers a focused beam of radiation to the trigeminal nerve to relieve pain in as many as 80% who have the procedure done.
- Pain relief may be gradual
- No anesthesia required
- May cause some facial numbness
- Other long term risks are unknown due to the procedure being new.
