Trigeminal neuralgia

Trigeminal neuralgia (also called tic douloureux)  is a condition that causes sudden, severe pain on one side of the face that can be triggered by simple activities such as talking, eating, or even a light breeze on the face. 

  • Causes: Trigeminal neuralgia is caused by irritation or damage to the trigeminal nerve, which supplies sensation (feeling) to the face. It is often caused by a loop of an artery or vein that presses on the trigeminal nerve. It is also common in people with multiple sclerosis.
  • Symptoms: The main symptom of trigeminal neuralgia is sudden, severe pain on one side of the face that can last for several seconds to several minutes. The pain can be triggered by simple activities such as talking, eating, or even a light breeze on the face.
  • Diagnosis: Trigeminal neuralgia is usually diagnosed based on the symptoms and medical history. Further tests, such as an MRI scan, may be needed to rule out other conditions and to see the position of the artery or vein loop.
  • Treatment: Treatment options for trigeminal neuralgia include medications, nerve blocks, radiation therapy and surgery. Carbamazepine is the most common medication treatment and is often effective. Surgery is only required if medications fail to control the pain. The type of surgery depends on the severity and frequency of the pain, as well as the overall health of the  patient. The most common surgery, microvascular decompression requires a craniotomy to move the artery or vein loop away from the nerve.
  • Prognosis: The prognosis for patients with trigeminal neuralgia varies depending on the underlying cause. It can be difficult to completely control the pain, although this is most likely to be achieved with surgery.

Gamma Knife Surgery for Trigeminal Neuralgia

The Gamma Knife surgery is a type of focussed radiation therapy that can be used to treat trigeminal neuralgia. 

  • How it works: The Gamma Knife uses high-dose radiation to target the source of the pain in the trigeminal nerve, without the need for an incision. The radiation damages the nerve fibres responsible for transmitting pain signals, reducing or eliminating the pain.
  • Benefits: The Gamma Knife can provide significant pain relief for trigeminal neuralgia with a lower risk of side effects compared to traditional surgery.
  • Procedure: The procedure is performed under local anaesthesia and takes several hours.
  • Recovery: After the procedure, patients may experience some swelling and discomfort in the treated area. They will need to follow a specific rehabilitation program to help with their recovery.
  • Risks and complications: As with any medical procedure, there are risks and potential complications associated with the Gamma Knife, including nerve damage. The pain may not always improve.

It is important to work closely with your healthcare team to develop a comprehensive treatment plan that is tailored to your individual needs and goals. The team will be able to provide you with more detailed information about your specific situation and help you understand what to expect.