Surgical long-term relief is available for facial pain
BY DR. KOMOROFF Universal Uclick
Monday, October 01, 2012
10/01/12 at 3:49 AM
Dear Doctor K: I have trigeminal neuralgia. Medications haven't helped. What are my other treatment options?
Dear Reader: Trigeminal neuralgia causes pain in the face. The pain can be so bad that it disrupts a person's life.
You have two trigeminal nerves, one on each side of your face. These nerves detect touch, pain, temperature and pressure. If you pinch your lip, trigeminal nerve endings in your lips send pain signals up the nerve and into your brain, where the pain registers.
In trigeminal neuralgia, a nerve starts to malfunction, registering pain when there's no apparent reason for it. People suddenly have intense, "stabbing" or electrical shock-like facial pain.
The irritation in a trigeminal nerve is usually near the nerve's origin, deep within the skull. In most cases, an abnormal blood vessel pressing on the nerve causes the irritation. In some cases, we just don't know the cause.
Treatment usually begins with the anticonvulsant medication. A muscle relaxant, either alone or in combination with an anticonvulsant, can also help.
Brief use of narcotic pain relievers, such as oxycodone, hydrocodone or morphine, can help manage episodes of severe pain.
There are other types of treatment to discuss with your doctor:
Rhizolysis Part of the trigeminal nerve is temporarily inactivated. This may be done using a heated probe, an injection of glycerol, or a tiny balloon inflated near the nerve to compress it. Rhizolysis doesn't prevent the condition from returning in the future.
Stereotactic radiosurgery Tiny beams of radiation are used to inactivate part of the trigeminal nerve.
Microvascular decompression A surgeon opens your skull and repositions the blood vessel that is pressing on your trigeminal nerve. The procedure has a high success rate, and most patients gain long-term relief.
Write Dr. K at www.AskDoctorK.com or c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106