Stephen J. Schueler, M.D.

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Trigeminal Pain Treatment

The goal in the treatment of trigeminal neuralgia is to reduce the frequency and intensity of the painful attacks of trigeminal neuralgia. Treatment for trigeminal neuralgia often includes oral medications and medication injections. Other options include surgery and radiation therapy.

Treatment options for trigeminal neuralgia include:

  • Avoiding pain triggers:
    • Do not perform activities that trigger the pain.
  • Oral medications for trigeminal neuralgia:
  • Medication injections for trigeminal neuralgia:
    • Glycerol injection for trigeminal neuralgia
    • Alcohol injection for trigeminal neuralgia
  • Balloon compression:
    • A needle is inserted through the face and into the area where the trigeminal nerve exits the skull. A balloon catheter is threaded into the area of the nerve and inflated to numb the nerve.
  • Stereotactic radiofrequency thermal rhizotomy:
    • A needle is inserted through the face and into the area where the trigeminal nerve exits the skull. An electrode is threaded into the area of the nerve and an electric current is passed through the tip to damage the nerve fibers.
  • Gamma knife radiosurgery (GKR):
    • Radiation is used to destroy the trigeminal nerve
  • Surgery for trigeminal neuralgia:
    • Microvascular decompression

Trigeminal Pain Drugs

The most common medications used for the treatment of trigeminal neuralgia include:

Additional medications used for the treatment of trigeminal neuralgia include:

Trigeminal Pain Questions For Doctor

The following are some important questions to ask before and after the treatment of trigeminal neuralgia.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • Will I need physical therapy?
  • What else can I do to reduce my risk for worsening symptoms of trigeminal neuralgia?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Trigeminal Pain Specialist

Physicians from the following specialties evaluate and treat trigeminal neuralgia:

Trigeminal Pain 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 Trigeminal Pain Home Care

Last Updated: Jun 9, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Trigeminal Pain 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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