What is trigeminal neuralgia?
Trigeminal neuralgia is a disorder of the trigeminal nerve, located in the skull base, that causes sudden bursts of intense face pain. The three branches of the trigeminal nerve run through the upper, middle and lower portions of each side of the face, and more than one nerve branch may be affected. Debilitating pain spasms may last just a few seconds to several minutes and may come in frequent waves. Patients never know when they will experience an episode of trigeminal neuralgia pain.
What are the symptoms of trigeminal neuralgia?
Many of those affected describe trigeminal pain as an electric shock, or a bolt of lightning. Oftentimes, sufferers mistake their pain for dental problems at first. Everyone agrees: The pain of trigeminal neuralgia is excruciating and unbearable.
Pain can radiate along the side of the face from the cheek to the lower jaw. Pain can affect the lips, tongue, teeth and gums. Trigeminal nerve pain can be triggered by light touch or cold around the mouth or face, or simply by talking, eating or brushing teeth. While trigeminal pain is usually limited to one side of the face, about 10 percent of those with trigeminal neuralgia will have pain on both sides of the face.
Gamma Knife® treatment for trigeminal neuralgia
Anti-seizure medications, such as carbamazepine (Tegretol), effectively control pain for a period of time, but they include many side effects. When medication is no longer effective, there are other treatment options for trigeminal neuralgia, but in general, they are invasive and pain relief can be short-term and may last for just a few years. Side effects of traditional treatment options can include permanent facial numbness or other damage.
Gamma Knife is an effective, lasting, minimally invasive treatment for trigeminal neuralgia with few or no side effects. The procedure targets the fifth cranial nerve at the skull base to interrupt pain signals to the brain. Gamma Knife uses images taken by magnetic resonance imaging (MRI) and pinpoint computer mapping to send a high dose of radiation to a highly defined target, while leaving surrounding healthy tissue unharmed.
How effective is Gamma Knife treatment for trigeminal neuralgia?
Gamma Knife provides acceptable pain relief for about 85 percent of patients. The average response to Gamma Knife treatment takes one to three months. However, some patients will notice a response right away, while others may find it can take up to one year to experience complete relief from trigeminal neuralgia pain. The best results with Gamma Knife occur when it is the first procedure chosen once medication is no longer effective, before other damaging procedures have been tried.
What is recovery like from Gamma Knife treatment for trigeminal neuralgia?
Gamma Knife is a minimally invasive treatment, so recovery is very mild and almost immediate. Patients do receive conscious sedation, so we encourage rest on the day of treatment after discharge. A few patients will have a headache or minor pain for a day or two at the four pin sites where the frame was anchored in position on the head, but most patients are able to resume normal daily activities within 24 hours.
When can I stop taking my trigeminal neuralgia medications?
After Gamma Knife treatment, patients begin a follow-up schedule with their radiation oncologist, neurosurgeon and neurologist. Once it is determined that the Gamma Knife treatment was effective, patients work with their neurologist to start tapering off trigeminal neuralgia medications. This could be as early as six months post-treatment to years later.
Do patients experience recurrence of trigeminal neuralgia after Gamma Knife?
About 30 percent of patients who have Gamma Knife for trigeminal neuralgia report a recurrence of their trigeminal pain.
Can I have Gamma Knife treatment more than once?
If patients do not experience full relief from trigeminal neuralgia after one year, Gamma Knife treatment may be repeated. This is a decision for patients to make with their neurosurgeon and radiation oncologist team.