FAQs on Trigeminal Neuralgia Treatment in Las Vegas

Trigeminal neuralgia (TN) is a painful condition that affects the trigeminal nerve (fifth cranial nerve that stems from the lower brain). With this disorder, the patient experiences shock-like severe pain.

How common is trigeminal neuralgia?

TN only affects around five people per 100,000. It usually affects people age 50 years and older.

What is the purpose of the trigeminal nerve?

The trigeminal nerve is one of 12 pairs of cranial nerves. This nerve has three sections: one supplies the eye and forehead regions, the second supplies the cheek area, and the third supplies the jaw. The symptoms of TN depend on which nerve branch is affected.

What are the two types of TN?

There are two forms of trigeminal neuralgia: type 1 TN, which causes extreme pain that only last for a short while, and type 2 TN, which causes aching, burning, and atypical pain.

What are the symptoms of trigeminal neuralgia?

The symptoms of TN occur when brushing teeth, drinking, applying makeup, and eating. The pain can lead to panic attacks, depression, and fear. People with this condition have trouble sleeping, worsening anxiety, and pain with chewing.

What can cause trigeminal neuralgia?

Trigeminal neuralgia is related to blood vessel compression on the trigeminal nerve. This damages the structures that protect the nerve. The problem occurs when there is contact between a normal blood vessel and the trigeminal nerve. Conditions that can cause TN include tumors, surgical injuries, stroke, facial trauma, multiple sclerosis, and arteriovenous malformation (mass of veins or arteries).

How is trigeminal neuralgia diagnosed?

There is no diagnostic test used to confirm trigeminal neuralgia. The diagnosis is made based on history and symptoms. Many disorders cause facial pain and mimic trigeminal neuralgia. The doctor will conduct a neurological examination, which includes examining and touching parts of the face and determining where the pain is located.

If the Las Vegas pain doctor suspects symptoms are caused by a compressed nerve or other condition, he/she may order a magnetic resonance imaging (MRI) scan. The doctor often injects dye into the vein or arteries near the nerve to identify problems (magnetic resonance angiogram).

How is trigeminal neuralgia treated?

The pain specialist may use a combination of therapies to treat trigeminal neuralgia. Treatment options include:

  • Medications – First-line treatments for TN are anticonvulsant medicines, such as oxcarbazepine and carbamazepine. Muscle relaxants are also used, such as Robaxin and Baclofen. For severe spasms, the doctor may use benzodiazepines, such as clonazepam. Narcotic analgesics are reserved for severe pain.

 

  • Microvascular decompression – This procedure is useful for patients who do not respond well with other therapies. This procedure involves decompressing the vessels around the nerve, usually by making a small incision behind the ear. Clinical studies show this procedure to have a 90% success rate.

 

  • Trigeminal nerve block – This involves insertion of a small needle into the side of the jaw so that a neurolytic agent or long-acting anesthetic can be instilled onto the nerve. For long-term pain relief, this procedure can be done in the Las Vegas pain specialist’s office.

 

  • Percutaneous stereotactic rhizotomy – With this procedure, electrocoagulation heat is used to destroy a portion of the nerve root. The doctor can insert a special needle through the cheek and project the heat.

 

  • Botox injections – Botulinum toxin A (Botox) injections can reduce the pain associated with trigeminal neuralgia. This is offered to people who do not respond to other therapies.

Resources

Manzoni GC & Torelli P (2005). Epidemiology of typical and atypical craniofacial neuralgias. Neurological Science, 26(Suppl 2), 65-67.

Obermann, M. (2010). Treatment options in trigeminal neuralgia. Therapeutic Advances in Neurological Disorders, 3(2), 107-115.