How to Treat Trigeminal Neuralgia

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. While it can be debilitating, there are several effective treatment options available. In the early stages, medication is often the first line of treatment. Anticonvulsants such as carbamazepine or oxcarbazepine are commonly prescribed to help manage the pain. These medications work by reducing the abnormal nerve signals that cause the intense, stabbing pain associated with the condition.

Challenges with Medication

Despite the initial effectiveness of drug therapy, some patients experience significant side effects. These can include dizziness, drowsiness, and in more severe cases, skin rashes or even life-threatening conditions like Stevens-Johnson syndrome. As a result, some individuals may not be able to tolerate long-term medication use. Additionally, while many patients respond well in the first year or two, the effectiveness of the medication often diminishes over time, prompting the need for alternative treatment approaches.

Understanding the Cause

Why Surgery May Be Necessary

Trigeminal neuralgia is typically caused by blood vessels pressing on the trigeminal nerve near the brainstem. This compression can lead to malfunction in the nerve's ability to transmit signals properly, resulting in episodes of extreme, shock-like pain in the face. The trigeminal nerve has three main branches: the ophthalmic (eye), maxillary (upper jaw), and mandibular (lower jaw) divisions. Most patients report intense pain in the maxillary and mandibular regions, often described as electric shocks or sharp knife-like sensations.

Microvascular Decompression: A Proven Solution

For long-term relief, microvascular decompression (MVD) surgery is widely regarded as one of the most effective treatments. This procedure involves relocating or removing blood vessels that are compressing the trigeminal nerve. Performed under general anesthesia, MVD offers a high success rate and is considered a safe and reliable option for patients who no longer respond to medication or who experience intolerable side effects. It is a well-established procedure in the field of neurosurgery and has been proven to provide lasting pain relief for many sufferers of trigeminal neuralgia.