Understanding the Treatment Options for Trigeminal Neuralgia

Trigeminal Neuralgia, or Tic Doulourex as it is sometimes known, is a rare neurological condition affecting approximately four people in every 100,000. It causes sudden and severe stabbing pains recurring in the face stemming from one or more branches of the trigeminal nerve. Trigeminal Neuralgia can be misdiagnosed as dental pain, but our pain specialists in Knoxville have a wealth of experience in treating the condition and can usually spot it quickly. Once diagnosed the appropriate course of action can be taken to manage the condition through medical or surgical options to relieve the sometimes-debilitating pain Trigeminal Neuralgia can cause.

Non-Surgical Treatment Options for Trigeminal Neuralgia

When it comes to treating a patient with Trigeminal Neuralgia, pain specialists in Knoxville know that medication is the first step. When dealing with nerve based pain, even the most minimally invasive surgical procedures carry risk and should always be the last resort. Following ongoing research and study, the most effective drugs for Trigeminal Neuralgia are those originally developed to treat epilepsy.

Anti-convulsant medication is commonly prescribed by pain specialists in Knoxville for treating Trigeminal Neuralgia. It is possible to provide partial, if not total pain relief for between 80 to 90 percent of patients. Muscle relaxants can also be prescribed either on their own or combined with pain relief. However, the drugs do not always remain effective over time, and a higher dosage may be needed. There can also be some unpleasant side effects including the following:

  • Dizziness
  • Drowsiness
  • Forgetfulness
  • Nausea

Surgical Treatment Options for Trigeminal Neuralgia

As briefly covered above, surgical treatments are often the last resort for Trigeminal Neuralgia. Even minimally invasive surgery can carry substantial risk. Pain specialists in Knoxville will usually reserve surgery for patients who are still experiencing debilitating pain even with the best possible pain management. If surgery is a possibility, the first step is to carry out a surgical evaluation on the patient. The evaluation will first confirm the trigeminal neuralgia diagnosis by way of an MRI, which can also eliminate other causes. The evaluating surgeon will then assess the severity of the pain, the general health and physical condition of the patient and discuss treatment goals.

The most common surgical procedure offered to Trigeminal Neuralgia patients is Microvascular Decompression (MVD). The treatment is also known as the Jannetta Procedure. The operation involves making a small incision behind the ear and drilling a hole in the skull. With the help of microscopic visualization, the trigeminal nerve is exposed. It is then possible to see if a blood vessel is compressing the nerve. If this is the case, it can be moved away from the vein, and a Teflon felt pad inserted. The pain is almost always relieved by the procedure.

MVD is considered major surgery, and as with any open-skull procedure, there are some potential risks that need to be taken into consideration. These include infection, excessive bleeding, hearing loss and stroke. When you consider the possible side effects, it is easy to understand why pain specialists in Knoxville prefer to try medical treatments before turning to surgical options.

Associated Pain Specialists (APS) has two Pain Management Clinics (one in Johnson City, TN and one in Knoxville, TN). Both locations can provide pain management options for patients including those living with chronic pain conditions. APS also operate the Smoky Mountain Ambulatory Surgery Center with its own on-site interventional pain specialist, orthopedic spine surgeon, and fellowship trained anesthesiologist.


Phone: (865) 673-5000

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