Trigeminal Neuralgia and Atypical Trigeminal Neuralgia Treatments
Medication
Trigeminal neuralgia is first treated with anticonvulsant drugs, and doctors may prescribe other medications as well. In many cases, patients are:
- Not helped by these medications
- Experience breakthrough pain
- Suffer undesirable side effects
In such cases, UPMC surgeons usually recommend one of the following treatments:
Microvascular decompression
Microvascular decompression is a minimally invasive surgical procedure using endoscopes that:
- Treats the cause of the problem
- Offers the most long-lasting relief
- Minimizes risk of postoperative side effects like numbness.
Microvascular decompression relieves abnormal compression of a cranial nerve. The surgery consists of a linear incision behind the ear followed by a craniectomy (bony opening) the size of a silver dollar.
Under the view of a microscope or endoscope, the surgeons detect the area where the blood vessel is affecting the nerve and then separate them, leaving a Teflon "pillow" in between.
Each year, more than 500 people with trigeminal neuralgia are treated at UPMC, including about 100 who undergo microvascular decompression.
This high volume allows doctors here to pursue research aimed at improving treatment effectiveness, making UPMC a world leader in the management of trigeminal neuralgia.
In the last 25 years, UPMC neurosurgeons have treated more than 20,000 patients with trigeminal neuralgia. Treatment provides:
- Immediate, complete relief in 82 percent of cases
- 16 percent achieve partial relief and require occasional or low-dose medication
One year after surgery:
- 75 percent of our patients continue to enjoy complete pain relief
- 8 percent have partial relief
Major complications occur in fewer than 5 percent of cases.
Gamma Knife® radiosurgery
Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.
Patients with typical trigeminal neuralgia who have had an adequate trial of medications can be offered Gamma Knife treatment. It is typically used for
- People with medical co-morbidities or pain that continues after surgical procedures
- People at risk for side effects from percutaneous ablative procedures
- People in more advanced age groups.
UPMC is the nation’s leading provider of Gamma Knife procedures. Over its 25-year history at UPMC, Gamma Knife stereotactic radiosurgery has proved effective for nearly 12,000 patients with:
- Benign or malignant brain tumors
- Vascular malformations
- Pain and other functional problems