Patients with longstanding trigeminal neuralgia that has not responded well to medical treatment may decide that it is time to work with a neurosurgeon to undergo another type of treatment.
A surgical treatment for trigeminal neuralgia is available. Microvascular decompression surgery is an open surgery during which a small hole is opened in the skull and the neurosurgeon places a small cushion between the trigeminal nerve and blood vessels that are pressing against it. Relieving that contact usually stops the pain.
This type of surgery requires anesthesia and a hospital stay. It is effective in about 80% of patients but it does carry certain risks, such as the possibility of:
- Cerebral spinal fluid leak
- Hearing loss
- Facial numbness
- In rare cases, bleeding, infection, seizures or paralysis
Gamma Knife Radiosurgery is a noninvasive treatment option.
Patients may also discuss treating their trigeminal neuralgia with Gamma Knife Radiosurgery. This is a noninvasive treatment—the patient does not have to undergo anesthesia and the treatment is nearly painless.
Trigeminal nerve pain occurs because a nerve is misfiring—essentially taking what is usually a harmless signal (“some wind is blowing on my face”) and turning it into a severe pain signal. The goal of the Gamma Knife treatment is to use precise radiation to deaden the part of the nerve that is overreacting while allowing other signals to go through.
Who Is a Good Candidate for Gamma Knife for Trigeminal Neuralgia?
Gamma Knife for trigeminal neuralgia might be preferable for patients who are older or who have other health problems that could make open microsurgery riskier, such as intolerance for anesthesia or difficulty with a breathing tube.
Another benefit for this treatment option is that patients will also be able to maintain their medical regimen before and during Gamma Knife treatment, until they and their physician decide it is time to see if the medications for trigeminal neuralgia are no longer needed.
Your Personal Recovery and Long-Term Results
Because the Gamma Knife procedure is noninvasive, patients may return home immediately afterward. They may experience a mild headache, but an over-the-counter pain reliever can help with that.
Like any major procedure, there are possible side effects with Gamma Knife. Some patients experience fatigue afterward, and others have some facial numbness, but for the overwhelming majority of patients who experience these side effects, they go away in a few weeks.
Importantly, roughly 80% patients who receive Gamma Knife Radiosurgery find their pain from trigeminal neuralgia greatly reduced or eliminated. However, some patients find that their symptoms return in four or five years because the treated portion of the nerve has healed itself. At that point, you and your surgeon can decide to repeat the Gamma Knife procedure, proceed to microvascular decompression or consider other alternative options.
If it is time to find an alternative to microvascular decompression surgery for your trigeminal neuralgia, The Gamma Knife Center at The Valley Hospital can help.
