The trigeminal nerve is located in the face and is responsible for carrying sensation from the face to the brain. When this nerve malfunctions, this leads to the development of trigeminal neuralgia, which is characterized by episodes of intense pain in the face. The treatment for this condition will depend on the underlying cause for symptoms, as well as your body’s response to the different types of medications.
Treatment for trigeminal neuralgia will typically begin with prescription medications to lessen or block the pain signals that are being sent to your brain. However, some people with this condition will stop responding to the medications after a certain period of time and may require other avenues of treatment. After diagnosis is confirmed, the medications that are usually prescribed first include:
Anticonvulsants: This includes medications such as carbamazepine (Tegretol), oxcarbazepine (Trileptal), lamotrigine (Lamictal), phenytoin (Dilantin), clonazepam (Klonopin), and gabapentin (Neurontin). These medications are usually successful in treating the symptoms of trigeminal neuralgia, though it is possible for the drug to lose its effectiveness over time. If this is the case, your doctor will likely increase the dose or recommend a switch to a different medication.
Antispasmodic agents: This includes medications such as baclofen (Gablofen). This type of medication may be used alone or in combination with the anticonvulsant medications to treat the symptoms of trigeminal neuralgia.
If your medication treatment plan for trigeminal neuralgia becomes ineffective or if you begin to experience uncomfortable or dangerous side effects, your doctor may recommend looking into surgical options for treating this condition. Some of the most common surgical procedures used for treating trigeminal neuralgia include:
Microvascular decompression: This is a procedure that involves relocating or removing the blood vessels that are in contact with the trigeminal root and placing a pad between the nerve and the arteries to prevent symptoms from occurring in the future. This procedure is usually successful in reducing or eliminating symptoms, though it is possible for pain to recur after some time has passed.
Gamma Knife radiosurgery: This is a procedure that involves directing a focused dose of radiation to the root of the trigeminal nerve in order to intentionally damage the nerve and reduce the pain that you are able to feel. This procedure is usually successful at treating this condition, but the results may take a few weeks before they are in full effect.
A rhizotomy is another type of procedure that can be used to treat trigeminal neuralgia that involves destroying the nerve fibers of the trigeminal nerve. There are different types of rhizotomy that use different methods for destroying the nerve fibers. These include:
Glycerol injection: This involves injecting a small amount of sterile glycerol directly on the trigeminal nerve to damage the nerve and block the pain signals.
Balloon compression: This involves using a balloon to create pressure on the trigeminal nerve to damage the nerve.
Radiofrequency thermal lesioning: This involves only destroying the nerve fibers that are associated with your pain by sending mild electrical currents through electrode tips while you are awake and able to respond to where you feel tingling.