by Dr. Michael Horowitz, Neurological Surgeon

Trigeminal neuralgia pain triggers one sided severe discomfort on the right or left side of the face. The pain is typically described as sudden, sharp, and electrical shock like discomfort lasting only a few seconds in duration. It usually involves one side of the upper, middle, and or lower face along the course of the three main branches of the trigeminal nerve. Sometimes, symptoms may also include sensations of facial pressure, burning, and numbness.

The trigeminal nerve is also called the 5th cranial nerve. It arises from a portion of the brain called the pons as well as from the upper spinal cord. This nerve performs two main functions. Function #1 is to allow us to have sensation from our face, tongue, mouth, teeth, eardrum, and the lining of the brain. Function #2 is to allow us to move our chewing muscles.

What causes Trigeminal neuralgia to flare up? No one knows for sure what causes Trigeminal neuralgia. Most physicians feel that it is due to a disturbance in the trigeminal nerve as it arises from a part of the brain called the pons. This disturbance is most likely an abnormality of the nerve’s insulation that causes different parts of the nerve to interact abnormally with other parts. This abnormal interaction leads to the severe pain. Pain is usually triggered or made worse by touching the face, kissing, talking, eating, brushing teeth, a cool breeze, or stress, but it may also occur spontaneously.

Trigeminal neuralgia treatment includes:

  1. Taking medications that help improve the nerve’s insulation or modulate the pain.
  2. Moving the blood vessels that are beating against the nerve and then placing a small pillow of Teflon between the nerve and the blood vessels so that the nerve is no longer struck by the blood vessels with each heart pulsation. This procedure is called a microvascular decompression (MVD). This method has greater than 85% chance of complete pain relief for patients with typical Trigeminal neuralgia.
  3. Exposing the nerve to a single focused large dose of radiation (Radiosurgery)
  4. Exposing the nerve to alcohol (Glycerol Rhizotomy)
  5. Exposing the nerve to an electric impulse (Electrothermal Rhizotomy)
  6. Partially crushing the nerve with a balloon (Balloon Rhizotomy)

If you think you may be suffering from Trigeminal neuralgia, Dr. Michael Horowitz can discuss each of these treatment options with you and recommend the best treatment for your particular case.

Dr. Michael Horowitz, Neurological Surgeon

February 18, 2021
Cranial nerve disorders affect the connections between cranial nerve centers within the brain.
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