Trigeminal Neuralgia: Which Medical Specialty Handles It?

Trigeminal neuralgia falls under the category of neurological disorders, which means the first point of consultation should be a neurology department. During the initial visit, doctors will determine whether the condition is primary or secondary trigeminal neuralgia. This distinction is crucial as it dictates the most appropriate treatment path and ensures an accurate diagnosis.

Understanding Secondary Trigeminal Neuralgia

For patients diagnosed with secondary trigeminal neuralgia, the underlying cause is often due to a tumor or other structural issue compressing the nerve. In such cases, neurosurgery is typically required to remove the tumor or alleviate the pressure. Following surgery, the pain generally subsides, offering long-term relief for many patients.

Treatment Options for Primary Trigeminal Neuralgia

Early-Stage Management

Primary trigeminal neuralgia typically presents with intermittent pain that may not be severe in its early stages. Patients experiencing mild symptoms with long intervals between pain episodes can often manage the condition through oral medication. One of the most commonly prescribed and effective medications is carbamazepine, which can be prescribed by specialists in neurology, neurosurgery, or pain management.

Advanced Treatment for Chronic Cases

For patients who have suffered from primary trigeminal neuralgia for more than six months and find that medication no longer provides sufficient relief, more advanced treatment options are available. In such cases, functional neurosurgery may be recommended, particularly microvascular decompression. This procedure offers immediate and lasting pain relief with relatively quick post-operative recovery.

Alternative Solutions for High-Risk Patients

Older patients or those with underlying health conditions such as cardiovascular disease may not be suitable candidates for major surgery. For these individuals, pain management clinics offer alternative approaches. Doctors can tailor medication regimens to better control symptoms, or perform minimally invasive procedures like radiofrequency ablation or balloon compression. While these procedures carry a lower risk, they come with a higher chance of recurrence and may result in facial numbness in some cases.