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Trigeminal neuralgia: Increasingly common, but there is relief

December 21, 2017

It’s described as the most excruciating pain known to humanity.

For most patients, the pain seems to begin out of nowhere. For others, the pain could follow dental surgery, a blow to the face, or a car accident. Regardless of when or what caused the pain to start, suffering from trigeminal neuralgia is miserable.

What is it?

Trigeminal neuralgia is caused by irritation of the trigeminal nerve, which has nerve branches into the forehead, cheeks and lower jaw. The pain is usually limited to one side of the face and typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye.

The three branches of the trigeminal nerve are responsible for providing sensation to the face:

  • The first branch controls sensation in a person's eye, upper eyelid and forehead.
  • The second branch controls sensation in the lower eyelid, cheek, nostril, upper lip and upper gum.
  • The third branch controls sensations in the jaw, lower lip, lower gum and some of the muscles used for chewing.

Symptoms

The pain can range anywhere from an intense, stabbing, electric shock-like pain to a more constant, aching, burning sensation. These intense flashes of pain can be triggered by:

  • Vibration or contact with the cheek (shaving, washing the face, or applying makeup)
  • Brushing teeth
  • Eating
  • Drinking
  • Talking
  • Being exposed to the wind

Trigeminal neuralgia is characterized by attacks that stop for a period of time and then return. The condition can be progressive, with attacks often worsening over time, and fewer and shorter pain-free periods before they recur. Eventually, the pain-free intervals disappear, and medication to control the pain becomes less effective. 

The disorder is not fatal, but it can be debilitating. Due to the intensity of the pain, some individuals may avoid daily activities or social contact because they fear an impending attack.

Who is affected?

According to The National Institute of Neurological Disorders and Stroke (NINDS), the incidence of new cases of trigeminal neuralgia is approximately 12 per 100,000 people per year. Though it can occur at any age, including infancy, it tends to occur most often in people over age 50 and is more common in women. 

Diagnosing

Diagnosing trigeminal neuralgia is primarily done by assessing a patient’s history and description of symptoms, along with results from physical and neurological examinations. Patients with trigeminal neuralgia eventually will undergo a magnetic resonance imaging (MRI) scan to rule out a tumor or multiple sclerosis as the cause of their pain. 

Treatment

There are several treatment options. Patients are generally prescribed medications that can relieve trigeminal neuralgia pain in more than 80% of cases. When patients cease to respond to medications or suffer from side effects, patients are offered more invasive treatment options such as surgery.

In the event than the patient is unable to undergo surgery or if an MRI shows a tumor as the underlying cause of trigeminal neuralgia, patients in the greater Dayton area have a non-invasive, cutting-edge treatment available to them, right in their own backyard. Kettering Health Network is the only health system in Dayton offering the Gamma Knife Perfexion.

Gamma Knife Perfexion is actually not a knife. It’s a type of radiosurgery, making it a non-invasive procedure with no surgical incision. This advanced radiation treatment uses up to 192 beams of radiation to treat brain tumors. Doctors are able to design treatments customized for each patient’s tumor.

The Gamma Knife Perfexion is the result of more than four decades of extensive research and clinical experience. The treatment offered at Kettering Health Network is the only one in Southwest Ohio and one of only a few in the world. 

The gamma knife offers:

  • painless, incision-free stereotactic radiosurgery
  • fast, precise treatment of one or more sites within one session
  • no anesthesia or overnight hospital stay

In addition, the gamma knife can be used to re-treat areas of the brain in the future.

Upcoming informational event

Kettering Health Network is hosting an event January 10 to discuss Trigeminal Neuralgia and treatment options including gamma knife.

Attendees will have an opportunity for a Q&A session with neurosurgeon Aqueel Pabaney, MD, who specializes in minimally invasive spine and brain surgeries for tumors, aneurysms, facial pain and skull base disorders.

For more information and to register for this free event, click here.