Effective Trigeminal Neuralgia Treatment Without Surgery

If you or a loved one has been diagnosed with trigeminal neuralgia, surgery might not be the only option for treatment.

It can be difficult to live every day of your life in pain. But the good news is that you have various options other than surgical procedures like Microvascular Decompression (MVD) to treat this painful condition.  

We will talk about your options for trigeminal neuralgia treatment such as Botox, glycerol rhizotomy, and gamma knife radiosurgery in the paragraphs to follow.

To truly understand what your best pain relief options are, you must explore them. Let’s start with the basics. 

What Is Trigeminal Neuralgia?

Trigeminal neuralgia is described as a nerve pain condition that impacts the side of your face.

The specific nerve impacted in this case is the trigeminal nerve. The trigeminal nerve is the fifth cranial nerve. It is the largest of the cranial nerves, as well as the most intricate.

Any of the three branches of the trigeminal nerve can be affected. Where the pain is felt depends on which parts of the nerve is affected.

Trigeminal neuralgia pain or facial numbness in this area can typically be caused by several factors such as aging, multiple sclerosis, or a tumor or blood vessel that presses on the nerve. There are cases where the cause remains unknown as well.

When pain is caused in a nerve, it is called neuralgia. Hence, the name Trigeminal neuralgia. It can occur in almost anyone, but most commonly occurs in women who are over the age of 50. 

trigeminal neuralgia treatment

Non-surgical Options for Trigeminal Neuralgia

Chances are you are here because you or a loved one has been diagnosed and are looking for non-surgical trigeminal neuralgia treatment options. Here are a few courses of action to consider when searching for non-surgical ways to treat trigeminal neuralgia.


When first diagnosed, patients are often told by their neurologist to start treating the pain with medication.

This modality can range from anticonvulsants, which help with preventing nerve irritation, to treating it with muscle relaxants and antispasmodic agents.

Anticonvulsants that are used are usually the same ones you would see in the treatment of a seizure disorder. Some examples of medication often used in this treatment are Gabapentin and Oxcarbazepine. The one that is used most often is called Carbamazepine.

Antispasmodic agents like Baclofen are usually used alone or in combination with anticonvulsants.

Common side effects with these medications are drowsiness, dizziness, nausea, or confusion.

Your physician can increase or decrease medications needed on an as-needed basis to a certain extent. Sometimes, medication alone will give you the relief you desire. 

Medication is not a cure and you may need to take them on a long-term basis. However, some people do find relief for a long period before they have to take the next step in the treatment guidelines for trigeminal neuralgia.

Some people even try natural treatments for the pain including vitamins or herbs during this stage.


Botox is used sometimes as a treatment when medication doesn’t work.

What is Botox? It is an injection that is often used to treat pain. It essentially blocks the nerve signal to certain target muscles to help provide relief from tightness, spasms, or pain.

Pain relief is not immediate with this treatment. It can take up to 20 days for pain relief to appear. Injections are typically repeated every 90 to 120 days for optimum results. 

As long as it works, Botox would be a treatment that you continuously repeat. It is also not a cure.

This study finds that injection of Botox in the mandibular and maxillary roots to be highly effective in treating trigeminal neuralgia. In fact, by six months after treatment, 88.9% of patients responded to treatment.

Side effects for Botox include, but are not limited to, facial asymmetry, pain at the site, weakness, difficulty swallowing, and headaches.

Glycerol Rhizotomy  

This is another option to treat the pain from trigeminal neuralgia.

During this procedure, your surgeon puts a glycerol injection into the affected area where the trigeminal nerve comes out of the skull. This will produce a numbing effect on that nerve.

Potential side effects can be bleeding, infection in the area of injection, nausea, and numbness.

When the nerve grows back, the pain may reoccur. When this happens, the procedure usually can be repeated. The effects of this procedure can last between one to six years.

Gamma Knife Radiosurgery

Gamma Knife Radiosurgery is a treatment that is ideal if medication isn’t working and your physician has told you it may be time for surgery. It has been known to be very effective in treating Trigeminal Neuralgia.

This procedure is a form of radiation therapy, where approximately 200 beams of radiation are used to focus on treating a specific area. This specific area is the trigeminal nerve. It targets the radiation on the Trigeminal nerve to stop or reduce the transmission of pain signals.

Gamma Knife is one of the most non-invasive breakthrough treatments. Moreover, because it only impacts the area you want to be treated, there are fewer side effects than traditional radiation therapy.

Afterward, the goal is to have less pain (or no pain) and a shorter recovery period as well.  Here are a few of the main steps of this procedure to understand.

Stabilizing your Head

A mask or headframe is often used to ensure the targeted treatment process. The headframe is most used and is made of lightweight carbon fiber.

CT Scan or MRI

The next step is imaging. Imaging is done on the same day of your treatment. The reason for this is to figure out the best treatment plan for you by finding the specific area that will need to be targeted with the treatment.

Imaging tests are painless and no preparation is usually needed to complete them.


Your Gamma Knife team will develop a personalized treatment plan, and discuss with you how long the procedure will take.

There isn’t much preparation time required for this procedure. You can eat and drink as usual. Here are a few considerations to keep in mind:

  • Plan to arrive 15 minutes before your appointment to make sure all of your paperwork is complete
  • We will position your headframe before the treatment process begins
  • When treatment is being delivered, you will be able to talk: It will not be noisy or painful, but you may feel pressure from the headframe

If you have concerns about claustrophobia, please let your doctor know so that they can address this beforehand.

After the procedure, you will go home. There typically aren’t many side effects to look out for other than a potential headache and mild pain from the headframe placement.

Your trigeminal neuralgia pain should gradually improve over the weeks and months that follow your treatment. It usually takes anywhere from 6 to 12 weeks for the pain to subside. Studies show that success rates range from 75 to 80%.

Results will vary on a patient-to-patient basis. Rarely, some patients need a second treatment to reach optimum results. Your doctor will also schedule several follow-up appointments to track your progress.

Why Choose Valley for Gamma Knife Radiosurgery?

We Have Invested in State-of-the-art Technology

We use the Leksell Gamma Knife Icon. It is our technology of choice because it is clinically proven with evidence-based performance.

Providing Compassionate Care Is One of Our Top Priorities

Our exceptional doctors and staff are focused on your journey. You will receive step-by-step empathetic guidance before, during, and after your procedure. We start with your outcome in mind.

Please feel free to take advantage of our patient resources at any time during your experience with us. You can also read what our patients have to say about their gamma knife treatment.

Our Experience

Our physicians have treated hundreds of patients successfully. Because of this, we are able to walk you through intricate details on the whole patient experience from start to end with your comfort and outcome in mind. We want you to know what to expect with every step of the treatment process.

Our team focuses on Patient and Family-Centered Care (PFCC) and  consists of several members to help you along the way:

  • Medical Care Team: Your team includes physicians, nurses, radiologists, physicists, social workers, and more
  • Patient Liaison: This person handles the administrative aspect of your experiences such as scheduling, insurance verification, and Gamma knife resources
  • Insurance and Financial Liaison: Responsible for your financial advocacy including financial counseling as well as any insurance details that come to play; we explain to you the cost, insurance coverage, and will contact your insurance company directly

Take Your Life Back with Trigeminal Neuralgia Treatment

Trigeminal neuralgia can be debilitating, but you don’t have to suffer. Treatments are available to help you find relief.

If Gamma Knife radiosurgery is a trigeminal neuralgia treatment that you are considering, please feel free to call our office or contact us here by calling or filling out the form.

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.

Get Your Questions Answered, By a Real Person.

Our Patient Liaison is here to help you understand your next step. After discussing your specific case, she can help you navigate your medical records, answer insurance questions, and connect you with one of our nurses, at no charge to you.

Patient liaisons explain Gamma Knife surgery cost, outcomes, etc.