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Overview

Trigeminal Neuralgia: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Trigeminal neuralgia is a condition that results in chronic pain in the face, particularly in the trigeminal nerve. This condition often occurs in women who are aged over 50, however there are fewer than a million cases per year in India, making this condition a rare one. The pain experienced as a part of this condition can often be triggered by speaking, chewing, or brushing the teeth. There is no cure for this condition and the treatment options mainly focus on making it a more manageable condition to live with.

Trigeminal neuralgia is treated with the help of medications. The medicines that will be prescribed function by blocking the pain receptors so that you don’t feel it. Pain management is a large part of living with this condition and you may be prescribed anti-spasmodic medicines, anticonvulsants, or even botox injections to help you with the pain. However, medication is not the only answer. There are many surgical procedures that can be used to control this condition and make it easier to live with. Some of the surgical options include microvascular decompression and brain stereotactic radio surgery. Since this condition occurs mainly in women over 50, the treatments that are employed take into consideration the patient’s medical history and age. Once the severity of the pain is mapped, the doctor will decide what treatment options will suit you the most.

How is the treatment done?

Trigeminal neuralgia is diagnosed on the basis of the type of pain you are experiencing, the part of the face that hurts, and the triggers that activate the pain. With this condition, the pain is often short and sharp and triggered by any stimulation to the cheeks, such as chewing, speaking, or even brushing your teeth. A neurological examination can help doctors understand what is causing the pain. In some cases, an MRI scan is also recommended to get a clearer picture of the problem. Once trigeminal neuralgia is diagnosed, the treatment can begin.

When it comes to the medicines that can be prescribed for this treatment, they range in type from antispasmodic and anticonvulsants, to botox injections. Anticonvulsants can help control the trigeminal nerve in the face in order to lessen the pain. Antispasmodic medications also work on a similar principal. Botox injections are also known to lessen the pain in the nerve, however further studies may be needed to substantiate this.

Trigeminal neuralgia can also be controlled with the help of surgical options. With microvascular decompression, an incision is made behind the ear on the side of the face where you feel the pain. The doctor removes the arteries and veins that come in contact with the nerve, and then adds a soft cushion between the nerve and other arteries. With brain stereotactic radio surgery, the goal is to destroy the root of this nerve. A controlled shot of radiation is given to the nerve to make it stop functioning. The relief in this form of treatment is gradual, but the treatment itself can be very effective. By destroying the nerve, you eliminate the chances of it transmitting the pain to your brain.

Who is eligible for the treatment? (When is the treatment done?)

Once trigeminal neuralgia is diagnosed, you can seek out the treatment. It is better to start with the medicinal treatments before going in for surgery. However, if they don’t work, you can certainly explore the surgical options.

Who is not eligible for the treatment?

Sometimes, pain in the face is caused to due multiple sclerosis. It may imitate the symptoms and signs of trigeminal neuralgia but it is an entirely different condition. If you are suffering from multiple sclerosis, then seeking out treatment for trigeminal neuralgia will not help you with your condition. The doctor must treat the sclerosis first for you to experience any relief from the pain.

Are there any side effects?

As is the case with most treatments, there are certain side effects to be vary of. Anticonvulsants can lead to side effects like dizziness, nausea, drowsiness, and confusion. Certain anticonvulsants have negative effects on people with Asian descent. Antispasmodic agents also have a few side effects such as confusion, drowsiness, and nausea. Multiple botox injections can eventually make it harder to move your face naturally. It can also give you a stiff and shiny appearance. Microvascular decompression has side effects that include stroke, facial numbness, loss of hearing, and facial weakness. Brain stereotactic radio surgery can lead to developing numbness in the face as well. Surgery in general comes with side effects like bruising, swelling, and pain.

What are the post-treatment guidelines?

With some medications, you have to monitor your diet and control your lifestyle. Since trigeminal neuralgia can mostly be treated through pain management techniques, identifying and controlling your exposure to your triggers can go a long way in helping you. For instance, if your trigger is a cold breeze that brushes against your cheek, you may have to limit your exposure to the same.

How long does it take to recover?

It can take up to a month for the treatment to start taking effect.

What is the price of the treatment in India?

The surgical treatments range in price from Rs. 50,000 to Rs. 1,50,000, depending on where you are getting the procedures done from.

Are the results of the treatment permanent?

There is no cure for trigeminal neuralgia, therefore the treatment results cannot be permanent. The treatment focusses on reducing and managing the pain you feel and you can expect the pain to swing from low to high throughout your life. The trick is to identify the treatment options that work best for you and continue to administer them as and when they are needed.

What are the alternatives to the treatment?

There are a few alternative treatments that are being explored for this condition. One such treatment is injecting glycerol injections at the base of the skull in order to damage the trigeminal nerve in the face. Balloon compression is also a treatment that can be used to damage the nerve sufficiently. Radiofrequency thermal lesioning can also be used for the same purpose. It damages the nerve fibres that are associated with pain.

Safety: High Effectiveness: Medium Timeliness: Medium Relative Risk: Low Side Effects: Medium Time For Recovery: Medium Price Range:

Rs. 50,000 - Rs 1,50,000

Popular Health Tips

Radiofrequency Ablation For Trigeminal Neuralgia!

MD,DNB, MBBS Bachelor of Medicine and Bachelor of Surgery, Fellowship In Pain Management
Pain Management Specialist, Mumbai

Trigeminal Neuralgia is a type of chronic pain disorder, which affects the trigeminal nerve. There are mainly two types:

Typical Trigeminal Neuralgia and Atypical Trigeminal Neuralgia.

The typical form or this disorder results in certain episodes of severe, sudden, shock-like pain in one side of the face, which lasts for seconds to few minutes.

Symptoms

Trigeminal Neuralgia may have symptoms which include one or more of patterns like the following:

  • Some episodes of severe,
  • Shooting pain which may seem like an electric shock.

A person might come across spontaneous attacks of pain or even attacks which might get triggered by certain things like touching the face, chewing, speaking or even while brushing the teeth.

Causes

When trigeminal neuralgia occurs, the trigeminal nerve’s function gets disrupted. The problem occurs through a contact between an artery or a vein and the trigeminal nerve at the base of one’s brain. This contact puts pressure on the nerve, thus causing it to malfunction.

Trigeminal Neuralgia can occur due to people getting aged or due to any kind of disorder that causes damage to the myelin sheath that protects certain nerves. A number of triggers can lead to the pain of trigeminal neuralgia, which include:

  • While shaving
  • When someone touches one’s face.
  • When a person is eating something.
  • While brushing teeth
  • Smiling
  • Washing one’s face.

What Is Radiofrequency Ablation for Trigeminal Neuralgia?

Radiofrequency Ablation or RFA is a technique by way of surgery, which helps to direct high-frequency heat on to the targeted areas of the body, such as tumors and tissues. When a person suffers chronic pain that means the high-frequency heat is getting targeted to the nerves.

A person suffering from trigeminal neuralgia, would have his or her doctor, who is a neurosurgeon, uses radiofrequency ablation to hit the trigeminal nerve, thereby destroying the nerve’s ability to get the pain signals transmitted to one’s brain.

Medication is the first line of treatment for trigeminal neuralgia by a neurosurgeon, to see how the patient reacts. If that person suffers from severe pain in the face and does not show any improvement through medication, then the doctor might recommend him/her to go for radiofrequency ablation surgery.

How Is The Procedure Conducted?

During the radiofrequency ablation for trigeminal neuralgia, people remain awake and asleep at different times. The process includes:

When the patient is asleep under the influence of general anaesthesia, a neurosurgeon would carefully place a needle through the corner of one’s mouth in order to reach the trigeminal nerve, which lies at the base of the skull. Then, once the X-rays confirm the needle is right in place, the neurosurgeon would wake the patient up, stimulate the nerve and ask the patient if he or she could feel the stimulation exactly at the place where the pain is experienced. This particular step confirms that the doctor has hit the right location. Once, the patient gets back to sleep, the doctor uses radiofrequency heat to minimally injure the nerve, sufficiently enough to induce a numb feeling on the face along with tingling, thus take the pain away.

4362 people found this helpful

Trigeminal Neuralgia - Things You Must Know About It!

DM - Neurology, MD - General Medicine
Neurologist, Ahmedabad
Trigeminal Neuralgia - Things You Must Know About It!

Trigeminal Neuralgia is basically a nervous disorder that can affect any person. The condition is caused mainly due to the trigeminal nerve or the 5th cranial nervebeing pressed against by a blood vessel. Cases have been reported without such specific underlying causes as well. The condition can cause light to severe pain and is treated through a combination of medication and other external stimulations.

Things you need to know about Trigeminal Neuralgia

  • Trigeminal Neuralgia is a condition in which the affected person will feel pain on one side of the face, especially on the cheeks and the mouth.
  • 'Tic douloureax’ is the other name by which the disorder is otherwise known.
  • Depending on the intensity of the pain, the condition is categorised as Type 1 or Type 2; type 1 Trigeminal Neuralgia being the one causing severe stabbing pain.
  • In rare cases, persons can experience both types at the same place at the same time.
  • The cause of Trigeminal Neuralgia, relates to the 5th Cranial nerve, which controls the facial sensation and chewing, being affected. Since this nerve is called the trigeminal nerve the disorder is named Trigeminal Neuralgia.
  • In a majority of cases, it has been detected that some blood vessel running along the nerve is pressing against the nerve, resulting in its inflammation and the pain being transmitted to the face.
  • Some experts believe the condition can be brought about without any known cause as well.
  • Radio-frequency ablation and microvascular decompression of nerve are very popular treatment methods followed by several practioners.
  • There are many ways of treating Trigeminal Neuralgia; internal medicine is, of course, the immediate remedy
  • Anticonvulsant drugs are the main line of medication prescribed primarily due to their ability to suppress nerve pain.
  • Certain antidepressants can also be prescribed in combination and some of the latest drugs which have been found to be very effective in treatment of Trigeminal Neuralgia are also recommended.
  • The doctors will, however, be closely monitoring the reactions and side effects before they persist with medication on these lines
  • Some of the external type of treatments for Trigeminal Neuralgia include the electrical stimulation using devices like TENS units.
  • These devices are freely available in the market and people can use them at their homes following the directions of use given by the manufacturers and also demo videos available online.
  • TENS is actually an acronym for “Transcutaneous Electrical Nerve Stimulation” and the devices consist of electrodes through which electric pulses are sent from a small transmitter like instrument. There are pads attached to the end of the electrodes that can be patched onto the skin and there is a range of settings to regulate the intensity of the pulses.
  • This electric stimulation process offers instant relief and when continuously applied for a few days, the pain may fully go away.

Nerve pains can become unbearable sometimes and have to be treated immediately. The best way is to first take a combination of drugs to control the pain and then use electric stimulation and other methods of external applications to remove the pain.

2003 people found this helpful

Home Remedies Trigeminal Neuralgia By Niramay Ayurveda

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Ayurveda, Ph.d Arthritic Disorder
Ayurveda, Surat
Home Remedies Trigeminal Neuralgia By Niramay Ayurveda

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain.

Home Remedies

Fried Methi (Fenugreek)                 100gm

Haldi (Turmeric)                               100gm

Ganthoda (Granthik)                       10gm

___________________________

Mix it properly

Dose: one tea Spoon Morning & Evening

Castrol oil – one tea spoon with warm water/ milk /tea at bed time once or twice in weak

Fried Lahsun- with ghee and take one two prices every day morning.

Fried Methi (Fenugreek)                 100gm

Sunthi-                                             100gm

Gud (Jagarry)                                   50gm

Ghee                                                 30gm

____________________________

Mix it properly and take two tea spoons early morning.

1 person found this helpful

Trigeminal Neuralgia - Understanding the Treatment Options!

MD, FIPM, CCEPC, Fellowship In Pain Management
Pain Management Specialist, Jaipur
Trigeminal Neuralgia - Understanding the Treatment Options!

Trigeminal neuralgia can be best described as an ongoing condition that affects a group of nerves called the fifth cranial nerve which is responsible for sensation in the face. Individuals suffering from this pain say that the pain feels like that of an electric shock and sometimes it becomes unbearably severe. According to medical experts, the trigeminal neuralgia is the acutest pain that an individual can suffer from where the pain mostly affects the lower portion of the face along with the jaw and may also affect the lips, nose, ears and eyes. Trigeminal neuralgia is thought to affect over 1 million people across the world and 1 person in every 15,000 people suffers from this disease.

Understanding the causes of trigeminal neuralgia
The human face comprises of two trigeminal nerves, one on each side of the face and each splits into 3 branches which aid in transmitting sensations of pain as well as a touch from the teeth, mouth, and face to the brain. Most cases of trigeminal neuralgia are said to be triggered by the blood vessels, which sometimes presses the root of the trigeminal nerve. This is known to make the nerve transmit signals which lead to the feeling of stabbing and throbbing pain in the facial regions.

The exertion of pressure on the nerves is mostly caused by multiple sclerosis and tumor and some other suspected causes of trigeminal neuralgia include, pressing of the blood vessel against the root of the trigeminal nerve, demyelization of the trigeminal nerves during the advanced stages of multiple sclerosis, physical damage to the nerve caused by an injury, a surgical procedure or a severe infection, although rare, pressing of a tumor against the trigeminal nerve may also cause it and family history and genetic conditions are also responsible for causing trigeminal neuralgia

Diagnosing trigeminal neuralgia:
If the primary health care provider feels that the symptoms of facial pain are indicative of trigeminal neuralgia, then the patient’s face is required to be examined and evaluated more carefully to detect the affected parts with precision. Other conditions which may have similar symptoms including tooth problems and sinusitis would be eliminated first. Then an MRI scan would be performed which would help understand whether the trigeminal neuralgia is triggered by some underlying medical issues. But the MRI would not be able to reveal the reasons behind the irritation of the nerve unless tumor or multiple sclerosis is the cause. This is because it is not possible to visualize the blood vessel that stands next to the nerve root.

Getting the right treatment for trigeminal neuralgia:

  1. Interventional Treatments: 
    • Percutaneous Radiofrequency(RF) Ablation of Gasserian Ganglion 
    • Percutaneous Glycerol Rhizolysis 
    • Percutaneous Baloon Micro compression 
  2. Surgical Microvascular Decompression (MVD) 
  3. Gamma Knife Stereotactic Radiation Therapy

If you wish to discuss any specific problem, you can consult a pain management specialist.

3797 people found this helpful

Trigeminal Neuralgia And Radio-Frequency Ablation - What Causes It?

MD, PDCC, MBBS Bachelor of Medicine and Bachelor of Surgery, FPCI
Pain Management Specialist, Delhi
Trigeminal Neuralgia And Radio-Frequency Ablation - What Causes It?

Trigeminal neuralgia is specified by the condition of a chronic pain that influences the trigeminal nerve. This nerve transfers sensation from one’s face to his/her brain. If a person is suffering from trigeminal neuralgia, then a gentle stimulation of face (sourced from brushing teeth or applying makeup) might generate a fright of agonizing pain. The affected person might experience short and mild attacks initially. However, the trigeminal neuralgia might progress and generate more-frequently and longer attack of severely critical pain. Women get affected by this situation more than men get and it is more prominently occur in individuals older than 50 years.

Trigeminal neuralgia does not mandatorily mean that you need to experience a lifelong pain. Various types of treatment alternatives are available and so doctors can usually handle the particular condition effectively by taking help of injections, medications or surgery. Various types of triggers might cause the pain regarding trigeminal neuralgia, such as eating, drinking, shaving, brushing teeth, touching face, smiling, washing face etc.

Symptoms

The symptoms of trigeminal neuralgia might comprise of one or more patterns and some of these are described below:

  1. Sequences of serious, jolting or shooting pain that might generate as an electric shock
  2. Spontaneous pain attacks or attacks stimulated by different activities like face touching, speaking, chewing, or brushing teeth. Pain attacks last from a few moments to some minutes.
  3. It is not a comprehensive list because Trigeminal neuralgia hosts various other symptoms as well. If a person feels facial pain, specifically recurring or prolonged pain or if the person does not get relief through the utilization over-the-counter pain relievers, then that person must consult a doctor.

How does Radiofrequency Ablation treat Trigeminal Neuralgia?
Trigeminal Neuralgia is a chronic and painful condition that involves the trigeminal nerve. There are two separate trigeminal nerves on both sides of the face, which carry the sensations like pain from the face to the body. Each nerve has three branches- forehand, midface and chin and trigeminal neuralgia can cause intense pain in any of these areas.

Causes-

  • This occurs when the trigeminal nerve functioning is disrupted. When the blood vessel/artery and the trigeminal nerve at the base of your brain come in contact, it puts pressure on the nerves and causes pain.
  • It also occurs as a result of ageing or multiple sclerosis
  • A disorder that damages the myelin sheath protecting the nerves can trigger pain
  • Sometimes pain occurs from tumors, which compresses the trigeminal nerves
  • Surgical strokes, facial trauma or strokes can also be the root cause of excruciating pain

Triggers-

  1. Shaving
  2. Touching your face
  3. Eating and drinking
  4. Putting on makeup
  5. Brushing
  6. Washing your face

Symptoms-
The pain can be mild and for a shorter duration or it can happen frequently for longer durations. Some experience the pain in cycles where it can come and go for days or even for weeks. Gradually the intensity of the pain lessens.

Cure by Radio-frequency Ablation
The treatment of trigeminal neuralgia is often a challenging process in clinical practice. When medicines do not prove as effective, surgery is the desired option.

Procedure-

  1. After applying local anaesthesia, the Pain Specialist carefully inserts a needle through the corner of your mouth to reach the trigeminal nerve
  2. The doctors then wake up the patient after stimulating the nerves and ask them to feel the stimulation at the same place where they undergo pain. This confirms their targeted location
  3. Once you fall asleep again, the Pain Specialist uses radiofrequency heat to injure the nerve enough to create numbness and removes the pain

How Effective is Radio-frequency Ablation?
The pain is cured almost in 98% of the patients. 50% of patients report recurrence of pain after about two years. Hence the procedure can be repeated in the same patient if necessary.

4037 people found this helpful

Popular Questions & Answers

Hi I'm suffering from Trigeminal neuralgia and I'm taking gabapentin NT 400 mg for last 5 months twice a day. Does this effect my cholesterol or Uric acid?

MBBS
General Physician, Mumbai
Perse it should not affect your cholesterol or uricacid levels unless until proven otherwise

I have trigeminal neuralgia. I am taking tegrital Cr 200 mg 2 time per day for past 8 months Past two days the pain coming frequently what I have to do?

BAMS, MD-General Medicine, Phd - Kayachikitsa
Ayurveda, Bangalore
You can opt ayurveda medicines for fast and safe management. Take online consult appoinment. Avoid deep fried foods, excesss exposure to sun, cold and use hot water boiled in coriander daily and sip this daily.

I have trigeminal neuralgia since 6 months .I am taking tablets everyday but it seems no effect on me .What I would do?

International Academy of Classical Homeopathy, BHMS
Homeopath, Pune
Take hyper 200 once a day for 10days Led pal 12c 3tims day for 10days Eat flax oil tab which wil give u best results
2 people found this helpful

Hi, Yesterday I felt some pain on my right face nerve and pressure on eye what is it and medicine?

MBBS
General Physician, Mumbai
For pain take tablet paracetamol 650 mg and it can be a nerve pain which needs to be evaluated after clinical examination and Get your vital parameters of the body checked from a nearby doctor and follow up with findings
1 person found this helpful

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
Medications To Treat Pain
Hi,

I am Doctor Varun Singla International pain specialist doctor of reviving pain and spine centre. So today we will discuss about medicine. What is pain medicine? Who is a pain specialist? Then we'll go to the conditions which are being treated by page creation and you can help the people in the treatment of these conditions. Medicine which deals with the management of pain and who is a pain specialist doctor who specialises in pain in the use of minimally invasive non-surgical procedures.

So I see many patients who are coming to us and they are suffering from pain living with it and don t take treatment and unaware of the treatment that are available today in the modern medicine so many ways by which you can be treated by open position for example back pain, sciatica pain, joint pain, shoulder pain, Trigeminal Neuralgia facial pain many things in which you can see treatment. There are many ways to get rid of pain like physiotherapy, chiropractors, massage, manipulation surgery and minimally invasive procedures. In our houses, if someone has pain how do they go about it. They start with home based therapies, massages and then they will go to the chemist to buy a medicine a painkiller that is a dangerous thing.

That is not to be done and if the pain is not relieved they will go to the doctor like the orthopedician or a surgeon then their device do surgery. And many people will face now that should I go for a surgery? Has there a risk involved but they are not being cheated with medicine or physiotherapy. What to do? Here comes the role of interventional pain medicine which is a non surgical minimally invasive and leaving procedures so they can go for these procedures.

So how does a pain physician relieve the pain? What are the methods by which a pain physician relieves the pain? These are like injecting drugs to a target area under imaging like laparoscopy or ultrasound small needle like injection and second thing is radiofrequency ablation. 3rd Thing would be intrathecal pump spinal cord stimulator and then there is endoscopic spine surgery. It is a spine endoscopy so when should you visit the pain physician if you are having any chronic pain which is more than 3 months like back pain, sciatica neck, pain facial pain, trigonal Neuralgia, joint pains, poster camera neuralgias, shoulder pain, knee pain, crps for any of these Sonic Paints so you can visit to pain specialist who can get rid of your pain if you are suffering from any kind of chronic pain. Kindly visit the wine pain and spine centre thank you
Play video
Chronic Pain
Symptoms and Treatment for Chronic Pain

Hi. I am Dr. Shantanu Mullick from Navi Mumbai, Pain Clear Clinic. Today, the whole world is suffering from chronic pain.

Million patients they are suffering from different types of chronic pain like back pain, neck pain and cervical spondylosis. Mainly, due to their lifestyle disorders but they are also suffering from different complicated pains like cancer pain, but most of the patients they are suffering from chronic pain with frozen shoulder, knee pain, back pain. They are going for surgery but many times these surgeries may not help in that way. That is why this newer therapy, intreventional pain therapy which is nowadays throughout the world and very much effective to support this kind of chronic pain to rule out the disease as well as to treat the level of the root cause.

Normally, the patients who are suffering from the back pain, many times I have seen that after regular therapy , physiotherapy, exercise, they are not getting relief and they are going for the surgery. In those cases, interventional pain therapy will help the to rule out the cause. We do treat these patients according to MRI reports but all these treatments are done without surgery. So many times, surgery may not help these kind of back pains and in cervical pains. So in those pains, interventional pain therapy, without damaging the anatomy helps a lot. So if you see the pain where we can see the patient is suffering from disc pain. We can see here the nerve root coming there and the disc is bulge and we commonly call it as slip disc problem or disc hernation. In those cases, the surgeons are getting the bones, there is a lamenectomy but without doing surgery as per MRI report we are under forescopic guidance in the operation theatre we are going inside the disc and treating them without any surgery and day care.

So patients automatically get very good relief and after that we are able to support the patients with physiotherapy exercises and this way we can help different types of patients suffering with back pain, neck pain. On the other hand, in case of cancer pain also when the patients are not getting relief with the morphine or from very strong pain killers, we can support them with interventional pain therapy to block their pains permanently working in the spinal cord.

Another, dreadful pain condition is trigeminal neuralgia where patient is suffering from pain in the face usually the pain comes where patients complain of sharp shooting, electric shock kind of pain. It will appear on one side of the face. Actually the trigeminal nerve is coming from the brain and it is supplying the nerves of the face in three ways. Usually it happens in one side and those patients initially are treated with medical therapy and any times they are not getting support in those cases we are treating with radiofrequency ablation therapy. So different types of new treatments have for this chronic pain where patients without knowing their disease, they keep on taking pain killers and damaging their other organs of the body so that is why pain management nowadays is a very very effective subject and separate speciality to support the chronic pains those who are suffering from long types of disease.

At last, I want to say if you want to more about this, contact us through lybrate.com.


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