Trigeminal Neuralgia Treatment Options: Medication, Surgery & Home Remedies

Following a diagnosis of trigeminal neuralgia, one of your next steps is to learn about the available trigeminal neuralgia treatment options. Though trigeminal neuralgia used to be poorly understood, clinicians and researchers have worked together to learn more about the condition and now have effective treatment options to help you resolve your pain. Wherever you are in the treatment planning process, it can be helpful to understand all the options available to you in the tri-state area.

About Trigeminal Neuralgia

Understanding more about trigeminal neuralgia can be useful when learning about the different treatment options. The trigeminal nerve is responsible for relaying sensation, including pain, from the face to the brain. A patient with trigeminal neuralgia has an overactive trigeminal nerve.

Trigeminal neuralgia is characterized by excruciating bouts of pain in response to normal activities, such as talking and eating, as well as dull pain that tends to always be there. This often happens because something (typically a blood vessel next to the brain stem) is pressing on the nerve, setting off inappropriate signals. Very rarely, doctors are unable to find the cause of the condition.

Home Remedies for Trigeminal Neuralgia

Though you can’t resolve your trigeminal neuralgia using home remedies, there are things you can do to help alleviate your symptoms. Warm compresses on the side of the face can be soothing, and some patients find creams containing capsaicin helpful. Cold compresses might also ease the pain, but only if cold is not a trigger for episodes. It is also helpful to know and avoid what can trigger an attack for you.

Medications for Trigeminal Neuralgia

Prescription medications are typically the first line of treatment for trigeminal neuralgia, though the types of medicine might be different than you think. Your doctor will not prescribe you pain medication but will instead recommend something to help prevent the hyperactivity of the trigeminal nerve and keep painful attacks from happening. Possible medications include tricyclic antidepressants, muscle relaxants, and anti-seizure drugs.

Surgeries for Trigeminal Neuralgia

When management using medications is not enough to alleviate your symptoms, your doctor may recommend surgery as a treatment option for trigeminal neuralgia. This allows the surgeon to access the area and remove the structure that is impinging on your trigeminal nerve. There are two types of surgery used to treat trigeminal neuralgia available to patients in northern NJ: microvascular decompression and Gamma Knife radiosurgery.

Microvascular Decompression

Microvascular decompression is another form of surgery that can be used to treat trigeminal neuralgia. It still requires an incision and craniotomy, but the surgeon uses specialized instruments and visualization to limit the invasiveness of the procedure. The surgical area is much smaller, leading to a shorter hospital stay and recovery time than traditional surgery.

During microvascular decompression, the surgeon will access the area and place a tiny piece of Teflon felt between the blood vessel and the nerve, alleviating the pressure and allowing the nerve to move more freely. The doctor will close the surgical site with sutures or staples. Patients can expect to spend 2-3 days in the hospital and approximately one week recovering at home.

Gamma Knife Radiosurgery

Despite its name, Gamma Knife radiosurgery is not a surgical procedure at all and does not involve any incisions. Rather, it’s an advanced form of radiation therapy that is done in an outpatient setting. That means there is no hospital stay, and most patients are able to return to all daily activities (including work) within a day or so. The procedure is minimally invasive, with reduced healing time and discomfort as compared to surgical treatment options, as well as fewer surgical risks.

Gamma Knife radiosurgery uses 192 beams of highly focused, low energy radiation to target the blood vessel that is pressing on your trigeminal nerve. Because it is so accurate, Gamma Knife radiosurgery spares the healthy neighboring tissues, allowing the surgeon to target just the area of interest. As a result, there are fewer side effects and risks than other surgical treatment options for trigeminal neuralgia.

Treating Your Trigeminal Neuralgia in Northern NJ

As you work with your doctor to develop a treatment plan, he or she will recommend a trigeminal neuralgia treatment option that best suits your individual needs. Generally speaking, home remedies, such as warm compresses, are helpful to provide relief from symptoms but will not resolve the issue. Most patients will initially be put on a course of medication, such as an antidepressant, to reduce the incidence of painful attacks.

Should further intervention be required, microvascular decompression is a surgical approach that has been recommended in the past. However, most patients who are candidates for these treatments can also benefit from less invasive Gamma Knife radiosurgery, which accomplishes the same treatment goals with less risk and less painful healing time.

If your doctor has not discussed the use of Gamma Knife radiosurgery as a potential treatment option, you may wish to bring it up at your next appointment. There are specialists in the tri-state area who are experienced in treating trigeminal neuralgia using Gamma Knife radiosurgery, and your doctor may be able to provide you a referral to someone in the NJ area.

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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