Trigeminal Neuralgia: Symptoms, Treatment and Recovery

Increasing your understanding of your trigeminal neuralgia is a great way to help relieve some of the stress you may be feeling during this time. You likely have questions about your condition and treatment options. While your personal doctor will be the best person to help you understand the particulars in your individual case, it can be helpful to have a general understanding of trigeminal neuralgia before that conversation.

What is Trigeminal Neuralgia?

Trigeminal neuralgia, which was once difficult to diagnose and treat, is now better understood. Trigeminal neuralgia is a chronic pain condition characterized by excessive pain in response to normal daily activities. This includes things like speaking, laughing and brushing your teeth.

Most cases of trigeminal neuralgia are caused because something is irritating the trigeminal nerve, which is responsible for sensory information (including pain) from the face. As a result, typical activities trigger atypical pain signals. The most common culprit is a blood vessel impinging on the nerve, causing it to become hyperactive and fire inappropriately.

Tic Douloureux

You may have come across the term tic douloureux while learning more about your condition. This is simply another name for trigeminal neuralgia. The term translated from French literally means “painful tic,” an appropriate description of the condition. There is no difference between tic douloureux and trigeminal neuralgia, and the names are often used interchangeably.

Trigeminal Neuralgia Treatment Options

Your doctor will work with you to develop a treatment plan that best suits your individual condition and needs. However, it can be helpful to have an understanding of all the trigeminal neuralgia treatment options available in northern NJ.

The first line of trigeminal neuralgia treatment is often prescription medication. Medications that help reduce the activity of the trigeminal nerve can be helpful, including anti-epilepsy medications, muscle relaxers and anti-depressants. Interestingly, painkiller medications are not helpful in treating trigeminal neuralgia.

Unfortunately, medications do not work for everyone and they tend to lose effectiveness over time. This is because they help manage symptoms but do not address the root of the problem. When this happens, further treatment may be necessary. Two options are available for patients in NJ: microvascular decompression and Gamma Knife radiosurgery.

Microvascular decompression is a surgical procedure, which takes place in a hospital setting while you are asleep and comfortable. During the procedure, your neurosurgeon will use specialized instruments and microscopic visualization to access the area where a blood vessel is pressing on the trigeminal nerve. The neurosurgeon places a small piece of Teflon sponge between the two, relieving the pressure and preventing further irritation to the nerve.

By contrast, Gamma Knife radiosurgery is an outpatient procedure that does not involve sutures or surgery. Instead, your doctor uses nearly 200 individual beams of low-dose radiation to target the area of interest. This will help end the inappropriate pain signals, providing lasting relief without the need for surgery.

Side Effects & Risks of Trigeminal Neuralgia Treatment

Any medical procedure has related risks, which your doctor will take into consideration before making any treatment recommendations. While your doctor will explain any risks or side effects as they relate to your individual condition, having a thorough understanding beforehand will help you prepare for that discussion.

Trigeminal Neuralgia Surgery Side Effects & Risks

The risks and side effects related to trigeminal neuralgia surgery include:

  • Risks related to general anesthesia
  • Nausea and vomiting
  • Headaches
  • Fatigue
  • Bleeding and blood clots
  • Pain and infection at the incision site
  • Nerve damage, leading to numbness, dizziness and/or hearing loss (often temporary)

Gamma Knife Radiosurgery Side Effects & Risks

Risks and side effects following Gamma Knife radiosurgery for trigeminal neuralgia include:

  • Fatigue
  • Headache
  • Nausea and vomiting
  • Itching and bleeding at the head frame pin sites
  • Delayed swelling of the brain, treated using medication
  • Rarely, patients experience persistent facial numbness

Benefits of Trigeminal Neuralgia Treatment

The obvious benefit of any trigeminal neuralgia treatment is relief from the pain you are experiencing. However, there are some specific benefits of Gamma Knife radiosurgery vs. trigeminal neuralgia surgery that are worth highlighting. Benefits of Gamma Knife radiosurgery for trigeminal neuralgia include:

  • No surgical or general anesthesia risks
  • No overnight hospital stay
  • Return to normal activity levels in 1-2 days
  • Short, mild recovery
  • No incisions, sutures or scarring
  • No pain, bleeding or infection at any surgical site

Frequently Asked Questions

What causes trigeminal neuralgia?

Most cases of trigeminal neuralgia occur because something is pressing on the trigeminal nerve, causing inappropriate pain signals from the face. The most common culprit is a blood vessel, though there can be other causes, such as a tumor. Rarely, the cause of a patient’s trigeminal neuralgia cannot be determined.

Do pain medications help with trigeminal neuralgia?

While medications can be used to treat trigeminal neuralgia, painkillers (such as opioids) are not effective.

Will I have to stay in the hospital after my trigeminal neuralgia treatment?

Patients undergoing microvascular decompression will need to spend at least a few days in the hospital recovering. However, there is no hospital stay following Gamma Knife radiosurgery.

When will I experience pain relief following trigeminal neuralgia treatment?

Pain relief following trigeminal neuralgia surgery typically occurs relatively quickly following surgery and could be complete or partial relief. If you undergo Gamma Knife radiosurgery for trigeminal neuralgia, most patients experience relief around the 8-week mark.

Patient Stories

Learning about other patients’ experiences can be a great way to set your mind at ease and prepare for your own upcoming treatment.

  • Meet Paul Brush, who thought he had a toothache but learned he had trigeminal neuralgia. He found relief following Gamma Knife radiosurgery for his trigeminal neuralgia.
  • Mary Hamilton also thought she was experiencing dental pain and lived with chronic pain for years. She’s been pain-free since her Gamma Knife radiosurgery procedure, which took less than an hour.

Trigeminal Neuralgia Recovery

Knowing what to expect following your trigeminal neuralgia treatment will help you prepare both mentally and physically. While your recovery will be an individual process, influenced by your personal health factors, understanding the process on a broad level will help you discuss what you can expect with your personal doctor.

Following trigeminal neuralgia surgery, you will likely spend 2-3 days recovering in the hospital. You may experience headaches and nausea during this time, which can be treated with medications. You will likely be very tired as your body heals. When you are discharged to begin your recovery at home, you can expect to be placed on activity restrictions. As your body regains strength, your doctor will gradually lift restrictions. Most patients are back to activities and work within three months.

By contrast, if you undergo Gamma Knife radiosurgery, you will be able to return home within a few hours of treatment and will be back to your daily activities in a day or two. You may have headaches and nausea, which are also treated with medications, and will likely be tired for the first couple of days. However, the recovery period is far milder when compared to surgery.

Your Individual Condition

You are a unique individual, and it will be important to work with a trigeminal neuralgia specialist in the tri-state area who can appreciate that. Whether you call it tic douloureux or trigeminal neuralgia, the bottom line is there are treatment options available to you in northern NJ to help ease your pain.

Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Dr. Anthony D’Ambrosio is a board-certified neurosurgeon that specializes in Neurosurgery, Stereotactic Radiosurgery, Gamma Knife Radiosurgery (GKRS) and more. He is the Director of Neurosurgery and Co-Director of the Gamma Knife Program at The Valley Hospital. Dr. D’Ambrosio is an expert in treating patients with trigeminal neuralgia, benign or malignant brain tumors, as well as many other neurological conditions.

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